Journal Description
Diagnostics
Diagnostics
is an international, peer-reviewed, open access journal on medical diagnosis published semimonthly online by MDPI. The British Neuro-Oncology Society (BNOS), the International Society for Infectious Diseases in Obstetrics and Gynaecology (ISIDOG) and the Swiss Union of Laboratory Medicine (SULM) are affiliated with Diagnostics and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, Inspec, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Medicine, General & Internal)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.7 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journal: LabMed.
Impact Factor:
3.6 (2022);
5-Year Impact Factor:
3.7 (2022)
Latest Articles
IL-6 Polymorphism as a Predisposing Genetic Factor for Gestational Diabetes or Preeclampsia Development in Pregnancy with Obesity in Relation to VEGF and VEGFF Receptor Gene Expression Modalities
Diagnostics 2024, 14(11), 1206; https://doi.org/10.3390/diagnostics14111206 - 6 Jun 2024
Abstract
The increased prevalence of obesity worldwide has been implicated in the alarming rise of the incidence of gestational diabetes and preeclampsia, which are both considered threatening conditions for both mother and fetus. We studied gene polymorphisms of the proinflammatory cytokine Interleukin 6 (IL-6)
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The increased prevalence of obesity worldwide has been implicated in the alarming rise of the incidence of gestational diabetes and preeclampsia, which are both considered threatening conditions for both mother and fetus. We studied gene polymorphisms of the proinflammatory cytokine Interleukin 6 (IL-6) and the gene expression levels of VEGF (vascular endothelial growth factor) and VEGF-R (endothelial growth factor receptor), all known to be involved in pregnancy complications, aiming to identify possible predisposing risk factors in pregnancies with obesity. The G allele of IL-6 was found to correspond with an increased risk for gestational diabetes and preeclampsia occurrence. Furthermore, in obese pregnant mothers with either gestational diabetes or pre-existing type 2 diabetes and those who developed preeclampsia, it was confirmed that gene expression levels of VEGF were reduced while they were increased for VEGF receptors. We conclude that the genetic profile of an obese pregnant woman shares a common background with that of a patient with pre-existing type 2 diabetes mellitus, and therefore predisposes them to complications in pregnancy.
Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
Open AccessArticle
Gastro-Esophageal Cancer: Can Radiomic Parameters from Baseline 18F-FDG-PET/CT Predict the Development of Distant Metastatic Disease?
by
Ricarda Hinzpeter, Seyed Ali Mirshahvalad, Roshini Kulanthaivelu, Andres Kohan, Claudia Ortega, Ur Metser, Amy Liu, Adam Farag, Elena Elimova, Rebecca K. S. Wong, Jonathan Yeung, Raymond Woo-Jun Jang and Patrick Veit-Haibach
Diagnostics 2024, 14(11), 1205; https://doi.org/10.3390/diagnostics14111205 - 6 Jun 2024
Abstract
We aimed to determine if clinical parameters and radiomics combined with sarcopenia status derived from baseline 18F-FDG-PET/CT could predict developing metastatic disease and overall survival (OS) in gastroesophageal cancer (GEC). Patients referred for primary staging who underwent 18F-FDG-PET/CT from 2008 to
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We aimed to determine if clinical parameters and radiomics combined with sarcopenia status derived from baseline 18F-FDG-PET/CT could predict developing metastatic disease and overall survival (OS) in gastroesophageal cancer (GEC). Patients referred for primary staging who underwent 18F-FDG-PET/CT from 2008 to 2019 were evaluated retrospectively. Overall, 243 GEC patients (mean age = 64) were enrolled. Clinical, histopathology, and sarcopenia data were obtained, and primary tumor radiomics features were extracted. For classification (early-stage vs. advanced disease), the association of the studied parameters was evaluated. Various clinical and radiomics models were developed and assessed. Accuracy and area under the curve (AUC) were calculated. For OS prediction, univariable and multivariable Cox analyses were performed. The best model included PET/CT radiomics features, clinical data, and sarcopenia score (accuracy = 80%; AUC = 88%). For OS prediction, various clinical, CT, and PET features entered the multivariable analysis. Three clinical factors (advanced disease, age ≥ 70 and ECOG ≥ 2), along with one CT-derived and one PET-derived radiomics feature, retained their significance. Overall, 18F-FDG PET/CT radiomics seems to have a potential added value in identifying GEC patients with advanced disease and may enhance the performance of baseline clinical parameters. These features may also have a prognostic value for OS, improving the decision-making for GEC patients.
Full article
(This article belongs to the Special Issue Abdominal Imaging: Recent Advances and Future Trends)
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Open AccessArticle
Enhancing Medical Image Retrieval with UMLS-Integrated CNN-Based Text Indexing
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Karim Gasmi, Hajer Ayadi and Mouna Torjmen
Diagnostics 2024, 14(11), 1204; https://doi.org/10.3390/diagnostics14111204 - 6 Jun 2024
Abstract
In recent years, Convolutional Neural Network (CNN) models have demonstrated notable advancements in various domains such as image classification and Natural Language Processing (NLP). Despite their success in image classification tasks, their potential impact on medical image retrieval, particularly in text-based medical image
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In recent years, Convolutional Neural Network (CNN) models have demonstrated notable advancements in various domains such as image classification and Natural Language Processing (NLP). Despite their success in image classification tasks, their potential impact on medical image retrieval, particularly in text-based medical image retrieval (TBMIR) tasks, has not yet been fully realized. This could be attributed to the complexity of the ranking process, as there is ambiguity in treating TBMIR as an image retrieval task rather than a traditional information retrieval or NLP task. To address this gap, our paper proposes a novel approach to re-ranking medical images using a Deep Matching Model (DMM) and Medical-Dependent Features (MDF). These features incorporate categorical attributes such as medical terminologies and imaging modalities. Specifically, our DMM aims to generate effective representations for query and image metadata using a personalized CNN, facilitating matching between these representations. By using MDF, a semantic similarity matrix based on Unified Medical Language System (UMLS) meta-thesaurus, and a set of personalized filters taking into account some ranking features, our deep matching model can effectively consider the TBMIR task as an image retrieval task, as previously mentioned. To evaluate our approach, we performed experiments on the medical ImageCLEF datasets from 2009 to 2012. The experimental results show that the proposed model significantly enhances image retrieval performance compared to the baseline and state-of-the-art approaches.
Full article
(This article belongs to the Special Issue Medical Data Processing and Analysis—2nd Edition)
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Open AccessArticle
Clinical and Hemodynamic Features of Aneurysm Rupture in Coil Embolization of Intracranial Aneurysms
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Tomoaki Suzuki, Hitoshi Hasegawa, Kohei Shibuya, Hidemoto Fujiwara and Makoto Oishi
Diagnostics 2024, 14(11), 1203; https://doi.org/10.3390/diagnostics14111203 - 6 Jun 2024
Abstract
Intraprocedural rupture (IPR) during coil embolization (CE) of an intracranial aneurysm is a significant clinical concern that necessitates a comprehensive understanding of its clinical and hemodynamic predictors. Between January 2012 and December 2023, 435 saccular cerebral aneurysms were treated with CE at our
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Intraprocedural rupture (IPR) during coil embolization (CE) of an intracranial aneurysm is a significant clinical concern that necessitates a comprehensive understanding of its clinical and hemodynamic predictors. Between January 2012 and December 2023, 435 saccular cerebral aneurysms were treated with CE at our institution. The inclusion criterion was extravasation or coil protrusion during CE. Postoperative data were used to confirm rupture points, and computational fluid dynamics (CFD) analysis was performed to assess hemodynamic characteristics, focusing on maximum pressure (Pmax) and wall shear stress (WSS). IPR occurred in six aneurysms (1.3%; three ruptured and three unruptured), with a dome size of 4.7 ± 1.8 mm and a D/N ratio of 1.5 ± 0.5. There were four aneurysms in the internal carotid artery (ICA), one in the anterior cerebral artery, and one in the middle cerebral artery. ICA aneurysms were treated using adjunctive techniques (three balloon-assisted, one stent-assisted). Two aneurysms (M1M2 and A1) were treated simply, yet had relatively small and misaligned domes. CFD analysis identified the rupture point as a flow impingement zone with Pmax in five aneurysms (83.3%). Time-averaged WSS was locally reduced around this area (1.3 ± 0.7 [Pa]), significantly lower than the aneurysmal dome (p < 0.01). Hemodynamically unstable areas have fragile, thin walls with rupture risk. A microcatheter was inserted along the inflow zone, directed towards the caution area. These findings underscore the importance of identifying hemodynamically unstable areas during CE. Adjunctive techniques should be applied with caution, especially in small aneurysms with axial misalignment, to minimize the rupture risk.
Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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Open AccessBrief Report
Evaluating the Compatibility of the Digit-in-Noise Test with Hearing Screening in Individuals with Intellectual Disabilities: A Pilot Study
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Noa Shmerler, Ronit Saban-Bezalel and Leah Fostick
Diagnostics 2024, 14(11), 1202; https://doi.org/10.3390/diagnostics14111202 - 6 Jun 2024
Abstract
Hearing impairment among adults with intellectual disability (ID) is notably prevalent yet frequently underdiagnosed due, in part, to the challenges associated with traditional hearing screening methods in this population. This study explores the effectiveness of the Digit-in-Noise (DIN) test as a viable alternative
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Hearing impairment among adults with intellectual disability (ID) is notably prevalent yet frequently underdiagnosed due, in part, to the challenges associated with traditional hearing screening methods in this population. This study explores the effectiveness of the Digit-in-Noise (DIN) test as a viable alternative for hearing screening within natural settings and with familiar personnel. A total of 16 Hebrew-speaking adults with ID were recruited from supported employment programs, 10 of whom completed the study. The DIN test, which was administered in a daily environment using a simple digital device, evaluated the speech recognition threshold in noise. Results indicated that while some participants performed comparably to typically developing individuals, others showed varying levels of hearing thresholds, suggesting diverse auditory capabilities within the ID population. This pilot study confirms that the DIN test can be feasibly integrated into routine care settings, offering a friendly and accessible method for assessing hearing abilities in adults with ID. The findings advocate for the broader adoption of and potential modifications to the DIN Test to enhance its applicability and inclusiveness, thereby improving diagnostic accuracy and subsequent auditory care for this underserved population.
Full article
(This article belongs to the Special Issue Trends in In Vitro Diagnostics Paving the Way to Next-Generation Healthcare)
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Open AccessReview
The Use of Physiotherapy in the Conservative Treatment of Cubital Tunnel Syndrome: A Critical Review of the Literature
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Michał Wieczorek, Rafał Gnat and Tomasz Wolny
Diagnostics 2024, 14(11), 1201; https://doi.org/10.3390/diagnostics14111201 - 6 Jun 2024
Abstract
Background: The lack of a clear answer regarding the efficacy of physiotherapy in the treatment of cubital tunnel syndrome (CuTS) has led to attempts to critically assess the scientific studies conducted to date. Materials and Methods: Two databases (MEDLINE via PubMed and PEDro)
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Background: The lack of a clear answer regarding the efficacy of physiotherapy in the treatment of cubital tunnel syndrome (CuTS) has led to attempts to critically assess the scientific studies conducted to date. Materials and Methods: Two databases (MEDLINE via PubMed and PEDro) and Google Scholar were used to search for papers. The inclusion criteria were randomized controlled trials, case series, and case reports that evaluate the effects of physiotherapy in the treatment of patients with CuTS. Results: A total of 18 studies met the eligibility criteria, capturing a total of 425 participants. Seven papers were randomized controlled trials, three more described prospective studies without a control group, and eight papers contained case reports. An analysis of the literature evaluating the effectiveness of various forms of broadly defined physiotherapy indicates that their use can have a beneficial effect in reducing many subjective and objective symptoms and improving function. In the majority of papers included in this review, their authors indicated positive therapeutic effects. Only one randomized controlled trial reported no change following therapy. It can therefore be stated that the results of the research conducted so far are optimistic. However, only 7 of the 18 papers were randomized controlled trials, while 3 were prospective studies, and 8 papers were case studies, in which 23 people with CuTS were studied. Conclusions: The small number of randomized clinical trials and their considerable heterogeneity do not allow firm conclusions to be drawn about the effectiveness of physiotherapy in the conservative treatment of CuTS.
Full article
(This article belongs to the Section Pathology and Molecular Diagnostics)
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Open AccessArticle
Management and Rehabilitative Treatment in Osteoarthritis with a Novel Physical Therapy Approach: A Randomized Control Study
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Teresa Paolucci, Marco Tommasi, Giannantonio Pozzato, Alessandro Pozzato, Letizia Pezzi, Mariachiara Zuccarini, Alessio Di Lanzo, Rocco Palumbo, Daniele Porto, Riccardo Messeri, Mirko Pesce, Andrea Pantalone, Roberto Buda and Antonia Patruno
Diagnostics 2024, 14(11), 1200; https://doi.org/10.3390/diagnostics14111200 - 6 Jun 2024
Abstract
Knee osteoarthritis (KOA) is a chronic degenerative disease characterized by progressive joint damage leading to significant disability. Although rehabilitative treatment methods for KOA have been widely implemented, the optimal integrated instrumental physical therapy approach remains unclear. Therefore, this study aimed to analyze the
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Knee osteoarthritis (KOA) is a chronic degenerative disease characterized by progressive joint damage leading to significant disability. Although rehabilitative treatment methods for KOA have been widely implemented, the optimal integrated instrumental physical therapy approach remains unclear. Therefore, this study aimed to analyze the effect of Quantum Molecular Resonance (QMR) on pain reduction as the primary outcome and the functional improvement in activity daily living (ADL) as a secondary outcome. The study was designed as a double-blind, randomized, controlled trial in an outpatient setting. Fifty-four (N = 54) patients were enrolled and then randomized into three groups according to a simple randomization list: Group 1 (intensive protocol, N = 22), Group 2 (extensive protocol, N = 21), and a Sham group (N = 11). Patients were evaluated over time with scales assessing pain and function. Treatment was performed with the QMR model electro-medical device, which generates alternating electric currents characterized by high frequency (4–64 MHz). The results showed that QMR had a positive effect with respect to the Sham group in terms of pain and function (p < 0.01), and intensive treatment was more effective than the extensive treatment in terms of “speed of response” to the treatment (p < 0.05). In conclusion, QMR in KOA could be effective in slowing the progression of clinical symptoms and improving patients’ pain and functionality and thus quality of life. Future studies will be necessary to investigate further treatment algorithms and therapeutic associations with rehabilitative exercise.
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(This article belongs to the Special Issue Rehabilitation Medicine: Diagnosis and Management)
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Open AccessArticle
Deep Learning-Based High-Resolution Magnetic Resonance Angiography (MRA) Generation Model for 4D Time-Resolved Angiography with Interleaved Stochastic Trajectories (TWIST) MRA in Fast Stroke Imaging
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Bo Kyu Kim, Sung-Hye You, Byungjun Kim and Jae Ho Shin
Diagnostics 2024, 14(11), 1199; https://doi.org/10.3390/diagnostics14111199 - 6 Jun 2024
Abstract
Purpose: The purpose of this study is to improve the qualitative and quantitative image quality of the time-resolved angiography with interleaved stochastic trajectories technique (4D-TWIST-MRA) using deep neural network (DNN)-based MR image reconstruction software. Materials and Methods: A total of 520 consecutive patients
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Purpose: The purpose of this study is to improve the qualitative and quantitative image quality of the time-resolved angiography with interleaved stochastic trajectories technique (4D-TWIST-MRA) using deep neural network (DNN)-based MR image reconstruction software. Materials and Methods: A total of 520 consecutive patients underwent 4D-TWIST-MRA for ischemic stroke or intracranial vessel stenosis evaluation. Four-dimensional DNN-reconstructed MRA (4D-DNR) was generated using commercially available software (SwiftMR v.3.0.0.0, AIRS Medical, Seoul, Republic of Korea). Among those evaluated, 397 (76.3%) patients received concurrent time-of-flight MRA (TOF-MRA) to compare the signal-to-noise ratio (SNR), image quality, noise, sharpness, vascular conspicuity, and degree of venous contamination with a 5-point Likert scale. Two radiologists independently evaluated the detection rate of intracranial aneurysm in TOF-MRA, 4D-TWIST-MRA, and 4D-DNR in separate sessions. The other 123 (23.7%) patients received 4D-TWIST-MRA due to a suspicion of acute ischemic stroke. The confidence level and decision time for large vessel occlusion were evaluated in these patients. Results: In qualitative analysis, 4D-DNR demonstrated better overall image quality, sharpness, vascular conspicuity, and noise reduction compared to 4D-TWIST-MRA. Moreover, 4D-DNR exhibited a higher SNR than 4D-TWIST-MRA. The venous contamination and aneurysm detection rates were not significantly different between the two MRA images. When compared to TOF-MRA, 4D-CE-MRA underestimated the aneurysm size (2.66 ± 0.51 vs. 1.75 ± 0.62, p = 0.029); however, 4D-DNR showed no significant difference in size compared to TOF-MRA (2.66 ± 0.51 vs. 2.10 ± 0.41, p = 0.327). In the diagnosis of large vessel occlusion, 4D-DNR showed a better confidence level and shorter decision time than 4D-TWIST-MRA. Conclusion: DNN reconstruction may improve the qualitative and quantitative image quality of 4D-TWIST-MRA, and also enhance diagnostic performance for intracranial aneurysm and large vessel occlusion.
Full article
(This article belongs to the Special Issue Clinical Advances and Applications in Neuroradiology)
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Open AccessArticle
Maternal Reassurance, Satisfaction, and Anxiety after First-Trimester Screening for Aneuploidies: Comparison between Contingent Screening and Universal Cell-Free DNA Testing
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Anna Luna Tramontano, Ilaria Marano, Giuliana Orlandi, Antonio Angelino, Maria Rivieccio, Caterina Fulgione, Giuseppe Maria Maruotti, Gabriele Saccone, Gabriella De Vita, Maurizio Guida and Laura Sarno
Diagnostics 2024, 14(11), 1198; https://doi.org/10.3390/diagnostics14111198 - 6 Jun 2024
Abstract
Background: This study aims to evaluate maternal reassurance, satisfaction, and anxiety after two different strategies for the first-trimester screening for aneuploidies. Methods: Patients between 11 + 3 and 13 + 6 weeks of gestation attending the first-trimester screening at Department of Mother and
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Background: This study aims to evaluate maternal reassurance, satisfaction, and anxiety after two different strategies for the first-trimester screening for aneuploidies. Methods: Patients between 11 + 3 and 13 + 6 weeks of gestation attending the first-trimester screening at Department of Mother and Child, University Hospital Federico II, Naples, Italy have been recruited and randomly allocated to contingent screening or universal cell-free fetal DNA testing (cffDNA). Questionnaires to measure reassurance, satisfaction, and anxiety have been filled twice: (Q1) after randomization and (Q2) after receiving results. Anxiety was measured by an Italian-version short form of the state scale of the Spielberger State–Trait Anxiety Inventory (STAI); child-related anxiety was measured by the 11-item Pregnancy-Related Anxiety Questionnaire—Revised Regardless of Parity (PRAQ-R2 scale); fear of bearing a physically or mentally handicapped child was measured considering only four items (item 4, 9, 10, and 11) of the PRAQ-R2 scale. Results: 431 patients were recruited: 205 (49%) were randomized in the contingent screening arm, 226 (51%) in the cfDNA arm. Maternal reassurance, satisfaction, and anxiety were not different in the two groups. Conclusion: A contingent screening for aneuploidies in the first trimester seems able to ensure the same maternal reassurance and satisfaction as a cfDNA analysis in the low-risk population and to not affect maternal anxiety.
Full article
(This article belongs to the Special Issue Insights into Perinatal Medicine and Fetal Medicine)
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Open AccessArticle
Dynamic Perviousness: A Novel Imaging Marker for Predicting Mechanical Thrombectomy Outcomes in Acute Ischemic Stroke
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Daniel F. Toth, Gergely Bertalan, Priska Heinz, Jawid Madjidyar, Patrick Thurner, Tilman Schubert and Zsolt Kulcsar
Diagnostics 2024, 14(11), 1197; https://doi.org/10.3390/diagnostics14111197 - 6 Jun 2024
Abstract
Background: The predictive value of thrombus standard perviousness (SP) in acute ischemic stroke (AIS) for the technical success rates of mechanical thrombectomy (MT) or functional outcomes is not yet conclusive. We investigated the relationship between dynamic perviousness (DP) and revascularization results using time-dependent
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Background: The predictive value of thrombus standard perviousness (SP) in acute ischemic stroke (AIS) for the technical success rates of mechanical thrombectomy (MT) or functional outcomes is not yet conclusive. We investigated the relationship between dynamic perviousness (DP) and revascularization results using time-dependent enhancement curve types determined with computed tomography (CT). Methods: A retrospective analysis of 137 AIS patients was performed. DP was calculated as the thrombus attenuation increase (TAI) using three time points and categorized into four groups: (1) no enhancement (CNE); (2) late enhancement (CLE); (3) early enhancement with washout (CW); (4) early enhancement without washout (CNW). Associations with the technical success rate and functional outcomes were assessed. Results: Late enhancement (CLE) had approximately two times higher odds for successful MT as compared to clots with other enhancement dynamics. The odds ratios (logistic regression model with CNW as the reference) for the TICI III scores were 4.04 (p = 0.067), 1.82 (p = 0.3), and 1.69 (p = 0.4) for CLE, CW, and CNE, respectively. The NIHSS scores at discharge and mRS scores at three months showed regression coefficients (linear regression model with CNW as reference) of −3.05 (p = 0.10), −1.17 (p = 0.51), and −1.24 (p = 0.47); and −1.30 (p = 0.097), −0.85 (p = 0.25), and −0.15 (p = 0.83) for CLE, CW, and CNE, respectively. Conclusions: Thrombi with late enhancement patterns showed a higher revascularization rate and better outcomes as compared to clots with early uptake or no washout.
Full article
(This article belongs to the Special Issue Advances in Cerebrovascular Imaging and Interventions)
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Open AccessArticle
Myocardial Work Indices Predict Hospitalization in Patients with Advanced Heart Failure
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Giulia Elena Mandoli, Federico Landra, Benedetta Chiantini, Lorenzo Bonadiman, Maria Concetta Pastore, Marta Focardi, Flavio D’Ascenzi, Matteo Lisi, Enrico Emilio Diviggiano, Luca Martini, Sonia Bernazzali, Serafina Valente, Massimo Maccherini, Matteo Cameli and Michael Y. Henein
Diagnostics 2024, 14(11), 1196; https://doi.org/10.3390/diagnostics14111196 - 6 Jun 2024
Abstract
Background: An increasing proportion of heart failure (HF) patients progress to the advanced stage (AdHF) with high event rates and limited treatment options. Echocardiography, particularly Speckle Tracking-derived myocardial work (MW), is useful for HF diagnosis and prognosis. We aimed to assess MW’s feasibility
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Background: An increasing proportion of heart failure (HF) patients progress to the advanced stage (AdHF) with high event rates and limited treatment options. Echocardiography, particularly Speckle Tracking-derived myocardial work (MW), is useful for HF diagnosis and prognosis. We aimed to assess MW’s feasibility in the prognostic stratification of AdHF. Methods: We retrospectively screened patients with AdHF who accessed our hospital in 2018–2022. We excluded subjects with inadequate acoustic windows; unavailable brachial artery cuff pressure at the time of the echocardiography; atrial fibrillation; and mitral or aortic regurgitation. We measured standard parameters and left ventricular (LV) strain (LS) and MW. The population was followed up to determine the composite outcomes of all-cause mortality, left ventricular assist device implantation and heart transplantation (primary endpoint), as well as unplanned HF hospitalization (secondary endpoint). Results: We enrolled 138 patients, prevalently males (79.7%), with a median age of 58 years (IQR 50–62). AdHF etiology was predominantly non-ischemic (65.9%). Thirty-five patients developed a composite event during a median follow-up of 636 days (IQR 323–868). Diastolic function, pulmonary pressures, and LV GLS and LV MW indices were not associated with major events. Contrarily, for the secondary endpoint, the hazard ratio for each increase in global work index (GWI) by 50 mmHg% was 0.90 (p = 0.025) and for each increase in global constructive work (GCW) by 50 mmHg% was 0.90 (p = 0.022). Kaplan–Meier demonstrated better endpoint-free survival, with an LV GWI ≥ 369 mmHg%. Conclusions: GWI and GCW, with good feasibility, can help in the better characterization of patients with AdHF at higher risk of HF hospitalization and adverse events, identifying the need for closer follow-up or additional HF therapy.
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(This article belongs to the Section Medical Imaging and Theranostics)
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Open AccessArticle
CXCR4 Expression as a Prognostic Biomarker in Soft Tissue Sarcomas
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Anna C. Virgili, Juliana Salazar, Alberto Gallardo, Antonio López-Pousa, Raúl Terés, Silvia Bagué, Ruth Orellana, Caterina Fumagalli, Ramon Mangues, Lorena Alba-Castellón, Ugutz Unzueta, Isolda Casanova and Ana Sebio
Diagnostics 2024, 14(11), 1195; https://doi.org/10.3390/diagnostics14111195 - 6 Jun 2024
Abstract
Poor long-term survival in localized high-risk soft tissue sarcomas (STSs) of the extremities and trunk highlights the need to identify new prognostic factors. CXCR4 is a chemokine receptor involved in tumor progression, angiogenesis, and metastasis. The aim of this study was to evaluate
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Poor long-term survival in localized high-risk soft tissue sarcomas (STSs) of the extremities and trunk highlights the need to identify new prognostic factors. CXCR4 is a chemokine receptor involved in tumor progression, angiogenesis, and metastasis. The aim of this study was to evaluate the association between CXCR4 expression in tumor tissue and survival in STSs patients treated with neoadjuvant therapy. CXCR4 expression was retrospectively determined by immunohistochemical analysis in serial specimens including initial biopsies, tumors post-neoadjuvant treatment, and tumors after relapse. We found that a positive cytoplasmatic expression of CXCR4 in tumors after neoadjuvant treatment was a predictor of poor recurrence-free survival (RFS) (p = 0.003) and overall survival (p = 0.019) in synovial sarcomas. We also found that positive nuclear CXCR4 expression in the initial biopsies was associated with poor RFS (p = 0.022) in undifferentiated pleomorphic sarcomas. In conclusion, our study adds to the evidence that CXCR4 expression in tumor tissue is a promising prognostic factor for STSs.
Full article
(This article belongs to the Special Issue Soft-Tissue Sarcoma: Diagnosis, Management and Promising Therapeutic Opportunities of Metastatic Disease)
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Open AccessArticle
Sodium–Glucose Cotransporter 2 Inhibitor Combined with Conventional Diuretics Ameliorate Body Fluid Retention without Excessive Plasma Volume Reduction
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Maki Asakura-Kinoshita, Takahiro Masuda, Kentaro Oka, Ken Ohara, Marina Miura, Masato Morinari, Kyohei Misawa, Yasuharu Miyazawa, Tetsu Akimoto, Kazuyuki Shimada and Daisuke Nagata
Diagnostics 2024, 14(11), 1194; https://doi.org/10.3390/diagnostics14111194 - 5 Jun 2024
Abstract
We previously reported that sodium–glucose cotransporter 2 (SGLT2) inhibitors exert sustained fluid homeostatic actions through compensatory increases in osmotic diuresis-induced vasopressin secretion and fluid intake. However, SGLT2 inhibitors alone do not produce durable amelioration of fluid retention. In this study, we examined the
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We previously reported that sodium–glucose cotransporter 2 (SGLT2) inhibitors exert sustained fluid homeostatic actions through compensatory increases in osmotic diuresis-induced vasopressin secretion and fluid intake. However, SGLT2 inhibitors alone do not produce durable amelioration of fluid retention. In this study, we examined the comparative effects of the SGLT2 inhibitor dapagliflozin (SGLT2i group, n = 53) and the combined use of dapagliflozin and conventional diuretics, including loop diuretics and/or thiazides (SGLT2i + diuretic group, n = 23), on serum copeptin, a stable, sensitive, and simple surrogate marker of vasopressin release and body fluid status. After six months of treatment, the change in copeptin was significantly lower in the SGLT2i + diuretic group than in the SGLT2i group (−1.4 ± 31.5% vs. 31.5 ± 56.3%, p = 0.0153). The change in the estimated plasma volume calculated using the Strauss formula was not significantly different between the two groups. Contrastingly, changes in interstitial fluid, extracellular water, intracellular water, and total body water were significantly lower in the SGLT2i + diuretic group than in the SGLT2i group. Changes in renin, aldosterone, and absolute epinephrine levels were not significantly different between the two groups. In conclusion, the combined use of the SGLT2 inhibitor dapagliflozin and conventional diuretics inhibited the increase in copeptin levels and remarkably ameliorated fluid retention without excessively reducing plasma volume and activating the renin–angiotensin–aldosterone and sympathetic nervous systems.
Full article
(This article belongs to the Special Issue Kidney Disease: Biomarkers, Diagnosis, and Prognosis: 3rd Edition)
Open AccessCommunication
Development of a Colorimetric Loop-Mediated Isothermal Amplification Assay for the Detection of Trypanosoma cruzi in Low-Resource Settings
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Taylor J. Moehling, Myla D. Worthington, Pui-Yan G. Wong, Season S. Wong and Robert J. Meagher
Diagnostics 2024, 14(11), 1193; https://doi.org/10.3390/diagnostics14111193 - 5 Jun 2024
Abstract
Chagas disease is an inflammatory parasitic infection caused by Trypanosoma cruzi (T. cruzi). Early diagnosis is crucial in guiding treatment and slowing disease progression; however, current diagnostic methods have insufficient detection limits and often require skilled technicians. Molecular tests, especially isothermal
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Chagas disease is an inflammatory parasitic infection caused by Trypanosoma cruzi (T. cruzi). Early diagnosis is crucial in guiding treatment and slowing disease progression; however, current diagnostic methods have insufficient detection limits and often require skilled technicians. Molecular tests, especially isothermal nucleic acid assays, are advantageous due to their excellent sensitivity, specificity, speed, and simplicity. Here, we optimized a colorimetric loop-mediated isothermal amplification (LAMP) assay for T. cruzi. We can detect as few as 2 genomic copies/reaction using three different T. cruzi strains. We examined selectivity using other parasitic protozoans and successfully detected T. cruzi DNA extracted from parasites in human whole blood down to 1.2 parasite equivalents/reaction. We also performed a blinded study using canine blood samples and established a 100% sensitivity, specificity, and accuracy for the colorimetric LAMP assay. Finally, we used a heated 3D printer bed and an insulated thermos cup to demonstrate that the LAMP incubation step could be performed with accessible, low-cost materials. Altogether, we have developed a high-performing assay for T. cruzi with a simple colorimetric output that would be ideal for rapid, low-cost screening at the point of use.
Full article
(This article belongs to the Section Point-of-Care Diagnostics and Devices)
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Open AccessArticle
Value of Ultrasound Super-Resolution Imaging for the Assessment of Renal Microcirculation in Patients with Acute Kidney Injury: A Preliminary Study
by
Xin Huang, Yao Zhang, Qing Zhou and Qing Deng
Diagnostics 2024, 14(11), 1192; https://doi.org/10.3390/diagnostics14111192 - 5 Jun 2024
Abstract
The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study—38 with AKI and 24
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The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study—38 with AKI and 24 control patients—from whom renal ultrasounds and clinical data were obtained. SonoVue contrast (1.5 mL) was administered through the elbow vein and contrast-enhanced ultrasound (CEUS) images were obtained on a Mindray Resona A20 ultrasound unit for 2 min. The renal perfusion time-intensity curve (TIC) was analyzed and, after 15 min, additional images were obtained to create a microscopic blood flow map. Microvascular density (MVD) was calculated and its correlation with serum creatinine (Scr) levels was analyzed. There were significant differences in heart rate, Scr, blood urea nitrogen, urine volume at 24 h, and glomerular filtration rate between the two groups (p < 0.01), whereas other characteristics, such as renal morphology, did not differ significantly between the AKI group and control group (p > 0.05). The time to peak and mean transit times of the renal cortex in the AKI group were prolonged compared to those in the control group (p < 0.01), while the peak intensity and area under the TIC were lower than those in the control group (p < 0.05). The MVD of the renal cortex in the AKI group was lower than that in the control group (18.46 ± 5.90% vs. 44.93 ± 11.65%; p < 0.01) and the MVD in the AKI group showed a negative correlation with Scr (R = −0.84; p < 0.01). Based on the aforementioned results, US SRI can effectively assess renal microcirculation in patients with AKI and is a noninvasive technique for the diagnosis of AKI and quantitative evaluation of renal microcirculation.
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(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management)
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Open AccessArticle
Enhancing Medical Image Classification with an Advanced Feature Selection Algorithm: A Novel Approach to Improving the Cuckoo Search Algorithm by Incorporating Caputo Fractional Order
by
Abduljlil Ali Abduljlil Habeb, Mundher Mohammed Taresh, Jintang Li, Zhan Gao and Ningbo Zhu
Diagnostics 2024, 14(11), 1191; https://doi.org/10.3390/diagnostics14111191 - 5 Jun 2024
Abstract
Glaucoma is a chronic eye condition that seriously impairs vision and requires early diagnosis and treatment. Automated detection techniques are essential for obtaining a timely diagnosis. In this paper, we propose a novel method for feature selection that integrates the cuckoo search algorithm
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Glaucoma is a chronic eye condition that seriously impairs vision and requires early diagnosis and treatment. Automated detection techniques are essential for obtaining a timely diagnosis. In this paper, we propose a novel method for feature selection that integrates the cuckoo search algorithm with Caputo fractional order (CFO-CS) to enhance the performance of glaucoma classification. However, when using the infinite series, the Caputo definition has memory length truncation issues. Therefore, we suggest a fixed memory step and an adjustable term count for optimization. We conducted experiments integrating various feature extraction techniques, including histograms of oriented gradients (HOGs), local binary patterns (LBPs), and deep features from MobileNet and VGG19, to create a unified vector. We evaluate the informative features selected from the proposed method using the k-nearest neighbor. Furthermore, we use data augmentation to enhance the diversity and quantity of the training set. The proposed method enhances convergence speed and the attainment of optimal solutions during training. The results demonstrate superior performance on the test set, achieving 92.62% accuracy, 94.70% precision, 93.52% F1-Score, 92.98% specificity, 92.36% sensitivity, and 85.00% Matthew’s correlation coefficient. The results confirm the efficiency of the proposed method, rendering it a generalizable and applicable technique in ophthalmology.
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(This article belongs to the Special Issue Classification of Diseases Using Machine Learning Algorithms)
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Open AccessArticle
Characterization and Antimicrobial Susceptibility Patterns of Enterococcus Species Isolated from Nosocomial Infections in a Saudi Tertiary Care Hospital over a Ten-Year Period (2012–2021)
by
Ali Al Bshabshe, Abdullah Algarni, Yahya Shabi, Abdulrahman Alwahhabi, Mohammed Asiri, Ahmed Alasmari, Adil Alshehry, Wesam F. Mousa and Nashwa Noreldin
Diagnostics 2024, 14(11), 1190; https://doi.org/10.3390/diagnostics14111190 - 5 Jun 2024
Abstract
Introduction: The Enterococcus genus is a common cause of nosocomial infections, with vancomycin-resistant enterococci (VRE) posing a significant treatment challenge. Method: This retrospective study, spanning ten years (2012 to 2021), analyzes antimicrobial susceptibility patterns of Enterococcus species from clinical samples in a Saudi
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Introduction: The Enterococcus genus is a common cause of nosocomial infections, with vancomycin-resistant enterococci (VRE) posing a significant treatment challenge. Method: This retrospective study, spanning ten years (2012 to 2021), analyzes antimicrobial susceptibility patterns of Enterococcus species from clinical samples in a Saudi Arabian tertiary care hospital. Result: A total of 1034 Enterococcus isolates were collected, 729 from general wards and 305 from intensive care unit (ICU) patients. VRE accounted for 15.9% of isolates. E. faecalis was the most common species (54.3% of isolates and 2.7% of VRE), followed by E. faecium (33.6% of isolates and 41.2% of VRE). E. faecium exhibited the highest resistance to ciprofloxacin (84.1%), ampicillin (81.6%), and rifampicin (80%), with daptomycin (0.6%) and linezolid (3.1%) showing the lowest resistance. In E. faecalis, ciprofloxacin resistance was highest (59.7%), followed by rifampicin (20.1%) and ampicillin (11.8%). Daptomycin (0%), linezolid (1.5%), and vancomycin (2.7%) had the lowest resistance. VRE cases had higher mortality rates compared to vancomycin-sensitive enterococci (VSE). Conclusion: Eight different strains of Enterocci were identified. E. faecalis was the most commonly identified strain, while E. faecium had the highest percentage of VRE. VRE cases had a significantly higher mortality rate than VSE cases.
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(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
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Open AccessReview
A Comprehensive Review on Alcohol Abuse Disorder Fatality, from Alcohol Binges to Alcoholic Cardiomyopathy
by
Antonina Argo, Walter Pitingaro, Maria Puntarello, Roberto Buscemi, Ginevra Malta, Tommaso D’Anna, Giuseppe Davide Albano and Stefania Zerbo
Diagnostics 2024, 14(11), 1189; https://doi.org/10.3390/diagnostics14111189 - 5 Jun 2024
Abstract
Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of
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Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of “Holiday Heart Syndrome”, linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.
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(This article belongs to the Special Issue Forensic Diagnosis: From New Method Development to Data Interpretation)
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Open AccessArticle
Post-Treatment Occurrence of Serum Cryoglobulinemia in Chronic Hepatitis C Patients
by
Gantogtokh Dashjamts, Amin-Erdene Ganzorig, Yumchinsuren Tsedendorj, Ganchimeg Dondov, Otgongerel Nergui, Tegshjargal Badamjav, Chung-Feng Huang, Po-Cheng Liang, Tulgaa Lonjid, Batbold Batsaikhan and Chia-Yen Dai
Diagnostics 2024, 14(11), 1188; https://doi.org/10.3390/diagnostics14111188 - 5 Jun 2024
Abstract
Background: Persistent cryoglobulinemia after the completion of antiviral treatment is an important consideration of clinical management in chronic hepatitis C patients. We aimed to investigate the occurrence of serum cryoglobulinemia in chronic hepatitis C patients without cryoglobulinemia at the initiation of antiviral treatment.
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Background: Persistent cryoglobulinemia after the completion of antiviral treatment is an important consideration of clinical management in chronic hepatitis C patients. We aimed to investigate the occurrence of serum cryoglobulinemia in chronic hepatitis C patients without cryoglobulinemia at the initiation of antiviral treatment. Methods: In total, 776 patients without cryoglobulinemia were assessed for serum cryoglobulinemia after the completion of anti-HCV treatment. Serum cryoglobulinemia precipitation was assessed upon both the initiation and the completion of the treatment and analyzed for the clinical laboratory factors associated with chronic hepatitis C. Results: One hundred eighteen (118) patients were checked for serum cryo-precipitation after the completion of the treatment, and eight patients (4.6%) were positive for serum cryoglobulinemia. The patients who tested positive for cryoglobulinemia included a higher proportion of liver cirrhosis patients (4/50%, p = 0.033) and other organ cancer patients (5/62.5%, p = 0.006) than patients who showed no signs of cryoglobulinemia after treatment. In a multivariate analysis, liver cirrhosis (odds ratio [OR]—17.86, 95% confidence interval [95% CI]—1.79–177.35, p = 0.014) and other organ cancer (OR–25.17 95% CI—2.59–244.23, p = 0.005) were independently and significantly associated with positive cryoglobulinemia 3 months after antiviral treatment. Conclusions: Three months after the antiviral DAA therapy had concluded, eight patients tested positive for cryoglobulinemia, representing a 6.7% prevalence. Liver cirrhosis and other organ cancer were independently and significantly associated with positive cryoglobulinemia after antiviral treatment. Further investigation into the causes of positive cryoglobulinemia after DAA antiviral therapy is warranted.
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(This article belongs to the Special Issue Editorial Board Members' Collection Series: Molecular Diagnostics of Infectious Diseases)
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Open AccessCase Report
Endovascular Stenting for Idiopathic Stenosis of the Superior Mesenteric Vein: A Case Report
by
Mugur Cristian Grasu, Radu Lucian Dumitru, Gina-Ionela Rusu-Munteanu, Mariana Mihaila, Mircea Manuc and Ioana Gabriela Lupescu
Diagnostics 2024, 14(11), 1187; https://doi.org/10.3390/diagnostics14111187 - 5 Jun 2024
Abstract
Idiopathic superior mesenteric vein (SMV) stenosis, where no clear causative factor is identifiable, remains a clinical rarity. We present a detailed case report of a patient with idiopathic stenosis of the SMV who underwent successful endovascular stenting. This report outlines the patient’s clinical
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Idiopathic superior mesenteric vein (SMV) stenosis, where no clear causative factor is identifiable, remains a clinical rarity. We present a detailed case report of a patient with idiopathic stenosis of the SMV who underwent successful endovascular stenting. This report outlines the patient’s clinical presentation, diagnostic imaging findings, procedural approach by the interventional radiology team, and subsequent management. Endovascular stenting is a viable therapeutic option for patients with idiopathic SMV stenosis. This case demonstrates that with appropriate interventional and post-procedural management, long-term stent patency and thrombosis prevention can be achieved. The success of this case encourages further investigation into endovascular treatments for venous stenoses.
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(This article belongs to the Special Issue Advances in Diagnostic and Interventional Radiology)
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