Diagnostic tests

Uterine myomas, fibroids or leiomyomas are benign neoplasms that can present as abnormal uterine bleeding and pressure symptoms. Significant complications are infrequent, but they can be life-threatening. This is a case of a ruptured fibroid where excessive intra-abdominal bleeding resulted in hemoperitoneum. In this clinical scenario, timely recognition and intervention were essential to prevent morbidity and mortality. This article discusses the diagnostic challenges and surgical management of a case of hemoperitoneum resulting from spontaneous haemorrhage from a ruptured vessel on the surface of a subserosal leiomyoma...

Anastomosing hemangioma (AH) is rare and a newly recognized variant of capillary hemangioma that is mostly found in the genitourinary tract. Additionally, AH is sometimes difficult to diagnose without pathological specimens. It is difficult to diagnose preoperatively due to the lack of specific clinical and radiologic appearance. The present report describes the imaging features from a radiological perspective and outlines the clinicopathologic features and treatment options. A 67-year-old woman was referred to Dokkyo Medical University Saitama Medical Center (Koshigaya, Japan) for a retroperitoneal tumor that was identified at a medical checkup 4 years prior...

Lung transplantation remains an important therapeutic option for idiopathic pulmonary arterial hypertension (IPAH), yet short-term survival is the poorest among the major diagnostic categories. We sought to develop a prediction model for 90-day mortality using the United Network for Organ Sharing database for adults with IPAH transplanted between 2005 and 2021. Variables with a p  value ≤ 0.1 on univariate testing were included in multivariable analysis to derive the best subset model...

Angiolipomas are rare, benign tumors characterized by a mixture of adipose tissue and blood vessels, distinguishing them from lipomas. This case involves a 52-year-old woman with no significant medical history who presented with generalized weakness, fatigue, and intermittent, painless rectal bleeding over six months, initially dismissed as hemorrhoidal. Despite exhibiting mild pallor and trace rectal bleeding upon examination, significant iron-deficiency anemia was diagnosed through laboratory tests. Incorporating colonoscopy and computed tomography, the diagnostic process identified a 2 cm submucosal lesion in the ascending colon, characterized as a well-defined, fat-density mass...

Background Renal insufficiency, a critical concern in native and transplant kidneys, necessitates effective screening modalities for evaluation and management. Grayscale sonography has been a cornerstone in renal diagnostics, providing basic anatomical insights such as renal length, cortical thickness, and collecting system dilatation. Despite technological advancements, its impact on the differential diagnosis or management of renal disease remains limited, often showing normal findings in the presence of severe renal dysfunction...

Introduction Pre-analytical errors in cytology laboratories can significantly impact the accuracy of diagnostic results and turnaround times, ultimately affecting patient care. This article presents an evaluation of pre-analytical errors and proposes fostering strategies to enhance accuracy and efficiency in the cytology laboratory of a tertiary care hospital. The background discusses the importance of pre-analytical processes in ensuring reliable cytological diagnoses and the common errors encountered in specimen collection, handling, and transportation...

Diagnosing community-acquired pneumonia (CAP) is increasingly challenging, especially with the emergence of atypical pathogens such as  Mycoplasma pneumoniae  and  Legionella pneumophila . This report presents the case of a 60-year-old male exhibiting lethargy and decreased oral intake, with a medical history marked by chronic kidney disease and benign prostate hyperplasia. Despite a positive  Legionella  urine antigen, the clinical and radiological profile did not align with  Legionella  pneumonia...

Systemic lupus erythematosus (SLE) is a remitting-relapsing systemic autoantibody and immune complex disease with a similar clinical presentation to that of malignancy and infection. The authors report a case of newly diagnosed SLE and lupus nephritis in a 48-year-old woman with constitutional symptoms and unintentional weight loss. Her presentation was further complicated by pericardial effusion and methicillin-resistant Staphylococcus aureus (MRSA) facial cellulitis and bacteremia. In the context of nonspecific symptoms and a wide initial differential diagnosis, the early consideration of rheumatologic etiologies and the involvement of consultant services led to appropriate diagnostic testing and a timely diagnosis...

PURPOSE: The diagnosis of irritable bowel syndrome (IBS) is based on symptom-based criteria due to lack of reliable disease-specific biomarkers. Gut microbiota is perturbed in IBS and when comparing different methods used to analyze gut microbiota, the results might be obscured. Therefore, in this systematic review we aimed to investigate the profile of fecal bacterial markers and dysbiosis index (DI) in patients with IBS and IBS subgroups compared to healthy controls (HCs) conducted by the same method (GA-map Dysbiosis Test based on16S rRNA sequencing)...

BACKGROUND: Sex and racial disparities in the presentation and management of chest pain persist, however, the impact of coronavirus disease 2019 (COVID-19) on these disparities have not been studied. We sought to determine whether the COVID-19 pandemic contributed to pre-existing sex and racial disparities in the presentation, management, and outcomes of patients presenting to the emergency department (ED) with chest pain. METHODS: We conducted an observational cohort study with retrospective data collection of patients between January 1, 2016, and May 1, 2022...

Many questions are raised, and challenges faced in the new era of (intranasal) bovine respiratory disease complex vaccination. An increase in vaccination rate is expected, due to its positive impact on cattle health, reduction of antimicrobial use and economic factors. However, engagement of farmers and veterinarians with regard to vaccination is often affected by limitations, resulting in the development of barriers to vaccination, but also opportunities to overcome these. The objective of the report is to provide practical recommendations and a consensus on best practises for BRDC vaccination, addressing barriers faced by veterinarians and farmers...

This proof-of-principle study presents the ability of the recently developed iLovEnose to measure ultratrace levels of volatile organic compounds (VOCs) in simulated human breath based on the combination of multiple gas sensors. The iLovEnose was developed by our research team as a test bed for gas sensors that can be hosted in three serially connected compact low-volume and temperature-controlled compartments. Herein, the eNose system was equipped with conventional semiconducting metal oxide (MOX) gas sensors using a variety of base technologies providing 11 different sensor signals that were evaluated to determine six VOCs of interest at eight low to ultralow concentration levels (i...

BACKGROUND: In staging early rectal cancers (ERC), submucosal tumor depth is one of the most important features determining the possibility of local excision (LE). The micro-enema (Bisacodyl) induces submucosal edema and may hypothetically improve the visualization of tumor depth. PURPOSE: To test the diagnostic performance of MRI to identify ERC suitable for LE when adding a pre-procedural micro-enema and concurrent use of a modified classification system. MATERIAL AND METHODS: In this prospective study, we consecutively included 73 patients with newly diagnosed rectal tumors...

Epidemiologic screening programs often make use of tests with small, but non-zero probabilities of misdiagnosis. In this article, we assume the target population is finite with a fixed number of true cases, and that we apply an imperfect test with known sensitivity and specificity to a sample of individuals from the population. In this setting, we propose an enhanced inferential approach for use in conjunction with sampling-based bias-corrected prevalence estimation. While ignoring the finite nature of the population can yield markedly conservative estimates, direct application of a standard finite population correction (FPC) conversely leads to underestimation of variance...

INTRODUCTION: Monocyte-to-lymphocyte ratio (MLR) is a convenient and noninvasive inflammatory biomarker, and inflammation has been reported to be associated with prostate cancer (PCa). Our objective was to ascertain any possible correlation between PCa and MLR. METHODS: We utilized data from the 1999-2020 cycles of the National Health and Nutrition Examination Survey (NHANES) regarding MLR and PCa. The independent associations of MLR and other inflammatory biomarkers (platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)) with PCa was investigated using weighted multivariate logistic regression and generalized additive models...

In certain low-income nations, the hepatitis Delta virus and hepatitis B virus (HBV) pose a serious medical burden, where the prevalence of hepatitis B surface antigen (HBsAg) is greater than 8%. Especially in rural places, irregular diagnostic exams are the main restriction and reason for underestimation. Utilizing serum samples from a Pakistani isolate, an internal ELISA for the quick identification of anti-HDV was created, and the effectiveness of the test was compared to a commercial diagnostic kit. HDV-positive serum samples were collected, and a highly antigenic domain of HDAg antigen was derived from them...

In the development of proteins, aptamers, and molecular imprints for diagnostic purposes, a major goal is to obtain a molecule with both a high binding affinity and specificity for the target ligand. Cushing syndrome or Addison's disease can be diagnosed by cortisol level tests. We have previously characterized and solved the crystal structure of an anti-cortisol (17) Fab fragment having a high affinity to cortisol but also significant cross-reactivity to other glucocorticoids, especially the glucocorticoid drug prednisolone...

BACKGROUND: Metagenomic next-generation sequencing (mNGS) is a novel diagnostic tool increasingly used in the field of infectious diseases. Little guidance is available regarding its appropriate use in different patient populations and clinical syndromes. We aimed to review the clinical utility of mNGS in patients with a specific clinical syndrome and identify factors that may increase its utility. METHODS: We retrospectively reviewed charts of 72 non-immunocompromised adults hospitalized with the clinical syndrome of 'fever of undetermined origin' and underwent mNGS testing...

Pyruvate dehydrogenase complex deficiency (PDCD) is a disorder of mitochondrial metabolism that is caused by pathogenic variants in multiple genes, including PDHA1 . Typical neonatal brain imaging findings in PDCD have been described, with a focus on malformative features and chronic encephaloclastic changes. However, fetal brain MRI imaging in confirmed PDCD has not been comprehensively described. We sought to demonstrate the prenatal neurological and systemic manifestations of PDCD determined by comprehensive fetal imaging and genomic sequencing...

BACKGROUND: Globally, over one-third of pulmonary tuberculosis (TB) disease diagnoses are made based on clinical criteria after a negative diagnostic test result. Understanding factors associated with clinicians' decisions to initiate treatment for individuals with negative test results is critical for predicting the potential impact of new diagnostics. METHODS: We performed a systematic review and individual patient data meta-analysis using studies conducted between January/2010 and December/2022 (PROSPERO: CRD42022287613)...