Diagnostics最新文献

{"title":"Ocular Structural and Vascular Changes in Patients with Severe Asymptomatic Carotid Disease After Undergoing Carotid Endarterectomy (CEA) and Carotid Artery Stenting (CAS).","authors":"Foteini Xanthou, Anna Dastiridou, Athanasios Giannoukas, Miltiadis Matsagkas, Chara Tzavara, Athanasios Chaidoulis, Sofia Androudi, Evangelia E Tsironi","doi":"10.3390/diagnostics15141826","DOIUrl":"10.3390/diagnostics15141826","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to prospectively assess the incidence of retinal embolization and to evaluate the vascular and structural changes in the retina and choroid in 52 patients with asymptomatic severe carotid artery disease who underwent carotid artery revascularization. <b>Methods</b>: In our study, 35 patients underwent carotid endarterectomy (CEA) and 17 underwent carotid artery stenting (CAS). Biomicroscopy, fundoscopy, optical coherence tomography (OCT), and OCT-angiography (OCTA) were performed at baseline and 1 month after revascularization. <b>Results</b>: The subfoveal choroidal thickness (SFCT), peripapillary choroidal thickness inferior to the optic nerve head (ppCTi), total overall average retinal vascular density (rVDtot), and total overall average choriocapillaris vascular density (ccVDtot) of the eyes ipsilateral to the operated carotid artery increased significantly after revascularization, whereas a statistically significant increase was also found in the SFCT, rVDtot, and ccVDtot of the contralateral eyes in the overall cohort. Comparing the two study groups, we found that the SFCT, superior and inferior peripapillary choroidal thicknesses (ppCTs, ppCTi), rVDtot, and ccVDtot increased in both groups after revascularization, but significantly only in the CEA group. Furthermore, the temporal choriocapillaris vascular density (ccVDt) increased significantly after revascularization in both groups to a similar degree. <b>Conclusions</b>: Carotid artery revascularization led to a statistically significant increase in retinal and choroidal vascular densities, which indicates significantly improved ocular perfusion. The analysis of the findings of the two study groups suggests the superiority of CEA in terms of improving ocular perfusion in asymptomatic severe carotid artery disease. The rate of retinal embolization was similar in both surgical groups.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alopecia Areata Associated with Dupilumab: National Database Study.","authors":"Tarun Sontam, Humaira Nfn, Jodi Yanking Li, Sehar Nadeem, Katie Beier, Neil K Jairath, Vignesh Ramachandran","doi":"10.3390/diagnostics15141828","DOIUrl":"10.3390/diagnostics15141828","url":null,"abstract":"<p><p><b>Background:</b> Alopecia areata (AA), an autoimmune condition causing non-scarring hair loss, often coexists with atopic dermatitis (AD) due to shared T-helper cell type 2 (Th2)-mediated pathways. Dupilumab, a monoclonal antibody inhibiting IL-4 and IL-13 signaling, is a cornerstone treatment for AD but has conflicting reports regarding its impact on AA, with some suggesting therapeutic benefits and others indicating AA induction. <b>Methods:</b> This retrospective study, utilizing the TriNetX Research Network's de-identified data from over 300 million patient records, investigates the association between dupilumab use and AA risk in AD patients. <b>Results:</b> After propensity score matching, 23,782 dupilumab users were compared with an equal number of controls. Results revealed a statistically significant increased AA risk in dupilumab users (odds ratio: 1.436, 95% CI: 1.066-1.935, <i>p</i> = 0.0167) after 16 weeks. Cases occurring within 16 weeks were excluded. <b>Conclusions:</b> Potential mechanisms include immune rebalancing, with Th2 suppression possibly upregulating Th1/Th17 pathways or unmasking latent AA in predisposed individuals. These findings challenge dupilumab's potential as an AA treatment and highlight the need for vigilant monitoring, including routine scalp examinations and patient education. Future research should focus on mechanistic pathways, risk stratification, and comparative studies with other biologics to optimize personalized treatment strategies for AD and AA.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergrader Agreement on Qualitative and Quantitative Assessment of Diabetic Retinopathy Severity Using Ultra-Widefield Imaging: INSPIRED Study Report 1.","authors":"Eleonora Riotto, Wei-Shan Tsai, Hagar Khalid, Francesca Lamanna, Louise Roch, Medha Manoj, Sobha Sivaprasad","doi":"10.3390/diagnostics15141831","DOIUrl":"10.3390/diagnostics15141831","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Discrepancies in diabetic retinopathy (DR) grading are well-documented, with retinal non-perfusion (RNP) quantification posing greater challenges. This study assessed intergrader agreement in DR evaluation, focusing on qualitative severity grading and quantitative RNP measurement. We aimed to improve agreement through structured consensus meetings. <b>Methods</b>: A retrospective analysis of 100 comparisons from 50 eyes (36 patients) was conducted. Two paired medical retina fellows graded ultra-widefield color fundus photographs (CFP) and fundus fluorescein angiography (FFA) images. CFP assessments included DR severity using the International Clinical Diabetic Retinopathy (ICDR) grading system, DR Severity Scale (DRSS), and predominantly peripheral lesions (PPL). FFA-based RNP was defined as capillary loss with grayscale matching the foveal avascular zone. Weekly adjudication by a senior specialist resolved discrepancies. Intergrader agreement was evaluated using Cohen's kappa (qualitative DRSS) and intraclass correlation coefficients (ICC) (quantitative RNP). Bland-Altman analysis assessed bias and variability. <b>Results</b>: After eight consensus meetings, CFP grading agreement improved to excellent: kappa = 91% (ICDR DR severity), 89% (DRSS), and 89% (PPL). FFA-based PPL agreement reached 100%. For RNP, the non-perfusion index (NPI) showed moderate overall ICC (0.49), with regional ICCs ranging from 0.40 to 0.57 (highest in the nasal region, ICC = 0.57). Bland-Altman analysis revealed a mean NPI difference of 0.12 (limits: -0.11 to 0.35), indicating acceptable variability despite outliers. <b>Conclusions</b>: Structured consensus training achieved excellent intergrader agreement for DR severity and PPL grading, supporting the clinical reliability of ultra-widefield imaging. However, RNP measurement variability underscores the need for standardized protocols and automated tools to enhance reproducibility. This process is critical for developing robust AI-based screening systems.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Plea for a Paradigm Shift from X-Ray to Ultrasound in Adults: An Update for Emergency Physicians, General Practitioners, Orthopedists and Sports Medicine Physicians.","authors":"Joseph Osterwalder, Beatrice Hoffmann, Mike Blaivas, Rudolf Horn, Eric Matchiner, Christoph F Dietrich","doi":"10.3390/diagnostics15141827","DOIUrl":"10.3390/diagnostics15141827","url":null,"abstract":"<p><p>This update is aimed at various specialists who deal with fractures, such as emergency physicians, general practitioners, orthopedists, and sports medicine physicians. The Global Burden of Disease 2019 Fracture Collaborators estimated the worldwide incidence to be at 178 million, i.e., 2.2 fractures per 1000 people per year. Traditionally, X-rays are the first choice for suspected fractures. However, many fractures can also be detected or excluded with ultrasound. This option is especially attractive when available at the \"point of care,\", i.e., at the patient's bedside in the ambulatory or emergency setting. Point-of-care ultrasound provides clinicians with a simple, cost-effective imaging tool without radiation and complex infrastructure. The evidence suggests that ultrasound has high diagnostic sensitivity and can reliably rule out many fractures with a high degree of certainty. When applied correctly, it could potentially save millions of radiographs and, in some cases, even compete with the accuracy of X-rays and CT scans. These findings suggest a potential paradigm shift. This update discusses the advantages of ultrasound, its examination technique, sonoanatomy of fractures, and relevant indication groups, including its application for analgesia through nerve, fascia, and fascial plane blocks. Ultrasound's diagnostic value supports its integration into routine fracture assessment, particularly in emergency and ambulatory care settings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analytical and Clinical Validation of the ConfiSign HIV Self-Test for Blood-Based HIV Screening.","authors":"Hyeyoung Lee, Ae-Ran Choi, Hye-Sun Park, JoungOk Kim, Seo-A Park, Seungok Lee, Jaeeun Yoo, Ji Sang Yoon, Sang Il Kim, Yoon Hee Jun, Younjeong Kim, Yeon Jeong Jeong, Eun-Jee Oh","doi":"10.3390/diagnostics15141833","DOIUrl":"10.3390/diagnostics15141833","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Since the World Health Organization (WHO) recommended HIV self-testing as an alternative to traditional facility-based testing in 2016, it has been increasingly adopted worldwide. This study aimed to evaluate the performance of the ConfiSign HIV Self-Test (GenBody Inc., Republic of Korea), a newly developed blood-based immunochromatographic assay for the qualitative detection of total antibodies (IgG and IgM) against HIV-1/HIV-2. <b>Methods</b>: The evaluation included four components: (1) retrospective analysis of 1400 archived serum samples (400 HIV-positive and 1000 HIV-negative samples), (2) prospective self-testing by 335 participants (112 HIV-positive participants and 223 individuals with an unknown HIV status, including healthy volunteers), (3) assessment using seroconversion panels and diverse HIV subtypes, and (4) analytical specificity testing for cross-reactivity and interference. The Elecsys HIV combi PT and Alinity I HIV Ag/Ab Combo assays were used as reference assays. <b>Results</b>: In retrospective testing, the ConfiSign HIV Self-Test achieved a positive percent agreement (PPA) of 100%, a negative percent agreement (NPA) of 99.2%, and a Cohen's kappa value of 0.986, showing excellent agreement with the reference assays. In the prospective study, the test showed 100% sensitivity and specificity, with a low invalid result rate of 1.8%. All HIV-positive samples, including those with low signal-to-cutoff (S/Co) values in the Alinity I assay, were correctly identified. The test also reliably detected early seroconversion samples and accurately identified a broad range of HIV-1 subtypes (A, B, C, D, F, G, CRF01_AE, CRF02_AG, and group O) as well as HIV-2. No cross-reactivity or interference was observed with samples that were positive for hepatitis viruses, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, influenza, HTLV-1, HTLV-2, or malaria. <b>Conclusions</b>: The ConfiSign HIV Self-Test demonstrated excellent sensitivity, specificity, and robustness across diverse clinical samples, supporting its reliability and practicality as a self-testing option for HIV-1/2 antibody detection.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Train-Time and Test-Time Computation in Large Language Models for Error Detection and Correction in Electronic Medical Records: A Retrospective Study.","authors":"Qiong Cai, Lanting Yang, Jiangping Xiao, Jiale Ma, Molei Liu, Xilong Pan","doi":"10.3390/diagnostics15141829","DOIUrl":"10.3390/diagnostics15141829","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This study examines the effectiveness of train-time computation, test-time computation, and their combination on the performance of large language modeling applied to an electronic medical record quality management system. It identifies the most effective combination of models to enhance clinical documentation performance and efficiency. <b>Methods:</b> A total of 597 clinical medical records were selected from the MEDEC-MS dataset, 10 of which were used for prompt engineering to guide model training. Eight large language models were employed for training, focusing on train-time computation and test-time computation. Model performance on specific error types was assessed using precision, recall, F1 score, and error correction accuracy. The dataset was divided into training and testing sets in a 7:3 ratio. The assembly model was created using binary logistic regression for assembly analysis of the top-performing models. Its performance was evaluated using area under the curve values and model weights. <b>Results:</b> GPT-4 and Deepseek R1 demonstrated higher overall accuracy in detecting errors. Models that focus on train-time computation exhibited shorter reasoning times and stricter error detection, while models emphasizing test-time computation achieved higher error correction accuracy. The GPT-4 model was particularly effective in addressing issues related to causal organisms, management, and pharmacotherapy, whereas models focusing on test-time computation performed better in tasks involving diagnosis and treatment. The assembly model, focusing on both train-time computation and test-time computation, outperformed any single large language model (Assembly model accuracy: 0.690 vs. GPT-4 accuracy: 0.477). <b>Conclusions:</b> Models focusing on train-time computation demonstrated greater efficiency in processing speed, while models focusing on test-time computation showed higher accuracy and interpretability in identifying and detecting quality issues in electronic medical records. Assembling the train-time and test-time computation strategies may strike a balance between high accuracy and model efficiency, thereby enhancing the development of electronic medical records and improving medical care.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Emerging Trend of At-Home Uroflowmetry-Designing a New Vibration-Based Uroflowmeter with Artificial Intelligence Pattern Recognition of Uroflow Curves and Comparing with Other Technologies.","authors":"Vincent F S Tsai, Yao-Chou Tsai, Stephen S D Yang, Ming-Wei Li, Yuan-Hung Pong, Yu-Ting Tsai","doi":"10.3390/diagnostics15141832","DOIUrl":"10.3390/diagnostics15141832","url":null,"abstract":"<p><p><b>Background/Objectives</b>: For aging men experiencing lower urinary tract symptoms (LUTS), bladder diaries (BD) and uroflowmetry (UFM) are commonly used non-invasive diagnostic tools. However, bladder diaries often suffer from subjectivity and incomplete data, while traditional hospital-based uroflowmetry lacks convenience and repeatability. Therefore, there is a growing need for a user-friendly, artificial intelligence (AI)-powered at-home uroflow monitoring solution. This study aims to develop a novel, vibration-based home uroflowmetry system capable of recognizing uroflow curve patterns and measuring voiding parameters, and to compare its performance with other existing home-based uroflowmetry methods. <b>Methods</b>: Seventy-six male participants, all of whom provided informed consent, underwent uroflowmetry to assess voiding symptoms. An accelerometer affixed to the uroflowmeter's urine container captured vibration signals, which were used to calculate the root mean square (RMS) values and maximum amplitude (Mmax). Simultaneously, the uroflowmeter recorded standard voiding parameters and generated uroflow curves. These vibration signals were then analyzed using a convolutional neural network (CNN) to classify six distinct uroflow curve patterns, aiding in diagnostic evaluation. <b>Results</b>: Seventy-six participants' voiding volume ranged from 50 mL to 690 mL (median [Q1, Q3]: 160 [70.00, 212.50] mL). The correlation analysis revealed positive correlations between the vibration signals and voiding parameters, including the voided volume and RMS (R = 0.768, <i>p</i> < 0.001), Qmax and Mmax (R = 0.684, <i>p</i> < 0.001), voiding time and signal time (R = 0.838, <i>p</i> < 0.001), time to Qmax and time to Mmax (R = 0.477, <i>p</i> < 0.001). AI pattern recognition demonstrated high accuracy with all three indicators (precision, recall, and F1 score) surpassing 0.97. <b>Conclusions</b>: This AI-assisted vibration-based home uroflowmetry enables accurate voiding parameter measurement and uroflow pattern recognition, showing high precision, recall, and F1-score. It might offer a convenient solution for continuous and subjective bladder monitoring outside clinical settings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning Network Selection and Optimized Information Fusion for Enhanced COVID-19 Detection: A Literature Review.","authors":"Olga Adriana Caliman Sturdza, Florin Filip, Monica Terteliu Baitan, Mihai Dimian","doi":"10.3390/diagnostics15141830","DOIUrl":"10.3390/diagnostics15141830","url":null,"abstract":"<p><p>The rapid spread of COVID-19 increased the need for speedy diagnostic tools, which led scientists to conduct extensive research on deep learning (DL) applications that use chest imaging, such as chest X-ray (CXR) and computed tomography (CT). This review examines the development and performance of DL architectures, notably convolutional neural networks (CNNs) and emerging vision transformers (ViTs), in identifying COVID-19-related lung abnormalities. Individual ResNet architectures, along with CNN models, demonstrate strong diagnostic performance through the transfer protocol; however, ViTs provide better performance, with improved readability and reduced data requirements. Multimodal diagnostic systems now incorporate alternative methods, in addition to imaging, which use lung ultrasounds, clinical data, and cough sound evaluation. Information fusion techniques, which operate at the data, feature, and decision levels, enhance diagnostic performance. However, progress in COVID-19 detection is hindered by ongoing issues stemming from restricted and non-uniform datasets, as well as domain differences in image standards and complications with both diagnostic overfitting and poor generalization capabilities. Recent developments in COVID-19 diagnosis involve constructing expansive multi-noise information sets while creating clinical process-oriented AI algorithms and implementing distributed learning protocols for securing information security and system stability. While deep learning-based COVID-19 detection systems show strong potential for clinical application, broader validation, regulatory approvals, and continuous adaptation remain essential for their successful deployment and for preparing future pandemic response strategies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Self-Treat or Not to Self-Treat: Evaluating the Diagnostic, Advisory and Referral Effectiveness of ChatGPT Responses to the Most Common Musculoskeletal Disorders.","authors":"Ufuk Arzu, Batuhan Gencer","doi":"10.3390/diagnostics15141834","DOIUrl":"10.3390/diagnostics15141834","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The increased accessibility of information has resulted in a rise in patients trying to self-diagnose and opting for self-medication, either as a primary treatment or as a supplement to medical care. Our objective was to evaluate the reliability, comprehensibility, and readability of the responses provided by ChatGPT 4.0 when queried about the most prevalent orthopaedic problems, thus ascertaining the occurrence of misguidance and the necessity for an audit of the disseminated information. <b>Methods:</b> ChatGPT 4.0 was presented with 26 open-ended questions. The responses were evaluated by two observers using a Likert scale in the categories of diagnosis, recommendation, and referral. The scores from the responses were subjected to subgroup analysis according to the area of interest (AoI) and anatomical region. The readability and comprehensibility of the chatbot's responses were analyzed using the Flesch-Kincaid Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). <b>Results:</b> The majority of the responses were rated as either 'adequate' or 'excellent'. However, in the diagnosis category, a significant difference was found in the evaluation made according to the AoI (<i>p</i> = 0.007), which is attributed to trauma-related questions. No significant difference was identified in any other category. The mean FKGL score was 7.8 ± 1.267, and the mean FRES was 52.68 ± 8.6. The average estimated reading level required to understand the text was considered as \"high school\". <b>Conclusions:</b> ChatGPT 4.0 facilitates the self-diagnosis and self-treatment tendencies of patients with musculoskeletal disorders. However, it is imperative for patients to have a robust understanding of the limitations of chatbot-generated advice, particularly in trauma-related conditions.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Hyperhemolysis in Sickle Cell Disease: Insights from Literature.","authors":"Sruthi Vellanki, Nishanth Thalambedu, Anup Kumar Trikannad Ashwini Kumar, Sravya Vellanki, Medhavi Honhar, Rachel Hendrix, Denese Harris, Mamatha Gaddam, Sunny R K Singh, Shivi Jain, Muthu Kumaran, Cesar Gentille, Ankur Varma","doi":"10.3390/diagnostics15141835","DOIUrl":"10.3390/diagnostics15141835","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is a prevalent genetic disorder caused by a mutation in the beta-globin gene. Hyperhemolysis (HS) is a severe complication involving the rapid destruction of both transfused and endogenous red blood cells, commonly found in SCD. This literature review explores the clinical presentation, diagnosis, pathogenesis, and management of HS in SCD. HS can manifest acutely or in a delayed manner, complicating diagnosis due to overlapping symptoms and varying reticulocyte responses. Immunohematological assessments often reveal delayed positivity in direct antiglobulin tests and antibody screens. HS typically presents severe anemia, jaundice, hemoglobinuria, and hemodynamic instability. Diagnostic markers include elevated bilirubin and lactate dehydrogenase levels alongside a reduced reticulocyte count. The management of HS is primarily empirical, with no clinical trials to support standardized treatment protocols. First-line treatments involve steroids and intravenous immunoglobulins (IVIG), which modulate immune responses and mitigate hemolysis. Refractory cases may require additional agents such as rituximab, eculizumab, tocilizumab, and, in some instances, plasma exchange or erythropoietin-stimulating agents. Novel therapeutic approaches, including bortezomib and Hemopure, have shown promise but require further investigation. Current management strategies are empirical, underscoring the need for robust clinical trials to establish effective treatment protocols that ultimately improve outcomes for SCD patients experiencing HS.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 14","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}