Diagnostics最新文献

{"title":"DTF-STCANet: A Dual Time-Frequency Swin Transformer and ConvNeXt Attention Network for Heart Sound Classification.","authors":"Mehmet Nail Bilen, Fatih Mehmet Çelik, Mehmet Ali Kobat, Fatih Demir","doi":"10.3390/diagnostics16081234","DOIUrl":"10.3390/diagnostics16081234","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Cardiovascular diseases are the leading cause of death worldwide. Therefore, early diagnosis and treatment of these diseases are of critical importance. Stethoscopes are the easiest and fastest medical devices for the initial diagnosis of cardiovascular diseases. However, interpreting heart sounds requires considerable expertise. The use of artificial intelligence in healthcare for decision support has increased and become popular recently. <b>Methods</b>: The popular 2016 PhysioNet/CinC Challenge dataset, consisting of phonocardiogram (PCG) signals, was used to implement the proposed approach. Spectrogram and continuous wavelet transform (CWT) images of the PCG signals were first generated. This increased the distinguishability of the data in terms of both time and frequency components. These two-input images were tested on the developed Dual Time-Frequency Swin Transformer-ConvNeXt Attention Network (DTF-STCANet) model. To further improve classification accuracy, the Weighted KNN algorithm was preferred during the classification phase. <b>Results</b>: With the proposed approach, a 99.29% classification accuracy was achieved. Performance was compared with other state-of-the-art models. <b>Conclusions</b>: The proposed approach, through the integration of PCG signals with artificial intelligence, further strengthens the concept of early diagnosis of heart disease.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812253","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":"Current Melioidosis Diagnostic Landscape and Missed Opportunities in Biomarker Development.","authors":"Sri Agung Fitri Kusuma, Santi Rukminita Anggraeni, Qurnia Wulan Sari, Neng Tanty Sofyana","doi":"10.3390/diagnostics16081247","DOIUrl":"10.3390/diagnostics16081247","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Melioidosis, caused by <i>Burkholderia pseudomallei</i>, is a severe tropical infectious disease associated with high mortality in endemic regions. Early diagnosis remains challenging because conventional diagnostic methods, including culture, serological assays, and molecular techniques, have limitations in sensitivity, specificity, processing time, and accessibility in resource-limited settings. This review evaluates current diagnostic approaches and highlights the potential of short peptide biomarkers for improving melioidosis detection. <b>Methods</b>: A narrative literature review was conducted using four electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) covering publications from 2000 to 2024. Relevant studies were identified using predefined keywords related to melioidosis diagnostics, biomarkers, and peptide-based approaches, and were screened based on relevance to diagnostic methods and peptide biomarker development in <i>Burkholderia pseudomallei</i>. <b>Results</b>: Several biomarkers have been investigated for melioidosis diagnostics, including capsular polysaccharide (CPS), type III secretion system 1 (TTS1), and other virulence-associated proteins such as Hcp1 and BPSS1187. Among these, CPS and TTS1 are highly conserved and specific targets widely used in molecular and antigen-based detection methods. Short peptide epitopes derived from these antigens demonstrate promising advantages over whole proteins, including improved stability, high specificity, easier synthesis, and reduced production costs. Advances in epitope prediction technologies and peptide-based biosensors have further expanded the potential applications of short peptides in rapid diagnostic platforms, including ELISA, lateral flow immunoassays, and biosensor-based detection systems. <b>Conclusions</b>: Short peptide-based biomarkers represent a promising strategy for developing rapid, sensitive, and cost-effective diagnostic tools for melioidosis, particularly in endemic and resource-limited settings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812168","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 Deep Learning Model for IMMP-Based Residual Disease Monitoring in AML with Monocytic Differentiation.","authors":"Jing Ding, Huiying Qiu, Chunling Zhang, Weilin Liu, Xinyi Jin, Ting Xu, Zongyue Lu, Jiatao Lou, Huidan Li","doi":"10.3390/diagnostics16081244","DOIUrl":"10.3390/diagnostics16081244","url":null,"abstract":"<p><p><b>Background:</b> Acute myeloid leukemia (AML) with monocytic differentiation poses significant clinical challenges, including high relapse rates and chemotherapy resistance. Current morphological assessment is limited by inter-observer variability, low sensitivity, and inefficiency, especially for detecting low-level residual disease. This creates an urgent need for automated, objective tools to improve diagnostic consistency and monitoring. Artificial intelligence, particularly deep learning, offers potential for extracting high-dimensional cytomorphological features to address these gaps. <b>Methods:</b> A retrospective cohort of 184 bone marrow smear slides from patients with monocytic leukemia was used. The core biomarker was the immature monocyte percentage (IMMP), defined as monoblasts plus promonocytes among nucleated cells, with a 2.0% clinical cutoff. An EfficientNet-based convolutional neural network was developed via transfer learning and trained to classify four cell types: monoblasts, promonocytes, monocytes, and other cells. <b>Results:</b> The model achieved robust cell-level classification, with F1 scores of 0.82 for monoblasts and 0.34 for promonocytes. At the slide level, using an optimized IMMP threshold of 0.045, it accurately assessed persistent leukemic cell burden with 78.9% <i>Accuracy</i>, 81.1% <i>Recall</i>, and 76.9% <i>Specificity</i>. Model-predicted IMMP values showed strong correlation with expert-derived values (Pearson r = 0.827), demonstrating reliable quantitative agreement. <b>Conclusions:</b> This deep learning model provides an automated, objective tool for quantifying immature monocytes, addressing key limitations in morphological assessment of monocytic AML. The IMMP metric shows promise for monitoring treatment response, predicting relapse, and potentially identifying patients at risk of venetoclax-based therapy resistance. While promising, prospective multicenter validation is needed to translate these findings into routine clinical practice.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812034","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":"Impact of Total Laboratory Automation on Urine Culture Turnaround Time: A Comparative Study Between Manual Workflow and WASPLab™.","authors":"Fizza Khalid, Ahmed J Alzahrani, Hilal Mohammed, Aymen Khalaf Allah Gamma, Mohamed Elhadi Hassan, Christy Poulose, Azza ElSheikh, Khalid Sumaily, Ahmad Ali Alharbi, Najah Fayyad Aldrous, Mohammed Alsaadan, Mohammed Alnamnakani, Osamah T Khojah","doi":"10.3390/diagnostics16081235","DOIUrl":"10.3390/diagnostics16081235","url":null,"abstract":"<p><p><b>Background:</b> Turnaround time (TAT) is a key performance indicator in clinical microbiology, particularly for urine cultures, which represent a high-volume workload and directly impact antimicrobial stewardship. <b>Methods:</b> This retrospective observational study compared urine culture TAT before (2023, manual workflow) and after (2025, total laboratory automation using WASPLab™) implementation in a high-volume reference laboratory. A total of 16,210 cultures in 2023 and 60,474 in 2025 were included. TAT was defined as the time from laboratory receipt to final report validation. <b>Results:</b> Implementation of total laboratory automation significantly reduced median TAT for both negative cultures (from 49.68 to 34.38 h) and positive cultures (from 50.42 to 34.62 h) (<i>p</i> < 0.001). In addition, variability in reporting times decreased, indicating improved consistency. Laboratory productivity increased from 2316 to 7559 cultures per full-time equivalent, representing a 3.26-fold improvement. <b>Conclusions:</b> Total laboratory automation significantly improved the speed and consistency of urine culture reporting, supporting enhanced laboratory efficiency and facilitating timely clinical decision-making.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812166","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":"Radiographic and Clinical Outcomes of Dual Mobility Total Hip Arthroplasty: A Retrospective Comparative Study from a Tertiary Centre.","authors":"Monica Georgiana Roman, Alexandru Lisias Dimitriu, Elisa Georgiana Popescu, Eduard Catalin Georgescu, Liliana Mirea, Razvan Ene, Dragos Ene","doi":"10.3390/diagnostics16081241","DOIUrl":"10.3390/diagnostics16081241","url":null,"abstract":"<p><p><b>Background:</b> Dual mobility (DM) total hip arthroplasty (THA) was introduced to reduce postoperative instability, one of the most frequent causes of revision after hip replacement. Its use has progressively expanded beyond revision surgery to selected high-risk primary cases; however, comparative data integrating both clinical and radiographic outcomes from real-world tertiary centers remain limited. <b>Methods:</b> A retrospective comparative study was conducted including 78 patients who underwent THA with a DM acetabular component between January 2019 and December 2024, and 78 matched controls who received conventional fixed-bearing THA during the same period. Matching criteria were age, sex, and procedure type (primary versus revision). Clinical outcomes were assessed using the Harris Hip Score (HHS) and visual analogue scale (VAS) for pain. Radiographic evaluation focused on component positioning, radiolucent lines, and signs of loosening. Complications and revision rates were compared between groups. <b>Results:</b> The mean age was 71 ± 9 years, and 62% of patients were female. Mean follow-up was 38 months. HHS improved from 54 ± 10 preoperatively to 89 ± 8 postoperatively in the DM group (<i>p</i> < 0.001), with similar final functional outcomes in the conventional THA group (90 ± 9, <i>p</i> = 0.48), and comparable improvement between groups (<i>p</i> = 0.62). Radiographic parameters demonstrated stable fixation and appropriate component positioning in both groups, with no significant intergroup differences. The dislocation rate was numerically lower in the DM group (1.3% vs. 5.1%), although this difference did not reach statistical significance (<i>p</i> = 0.37). No cases of intraprosthetic dislocation occurred. Overall implant survival free from revision at five years was 96.5% for DM and 94.7% for conventional THA (<i>p</i> = 0.47). <b>Conclusions:</b> DM THA achieved excellent clinical and radiographic outcomes, with a numerically lower dislocation rate than conventional THA. Mid-term implant survivorship was comparable between groups, supporting DM as a reliable option for improving stability in appropriately selected patients.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812182","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":"Application of Long-Read Whole-Genome Sequencing to Clarify Genotypic-Phenotypic Discrepancies in Methicillin-Resistant <i>Staphylococcus aureus</i>.","authors":"Jin Ho Jhang, Kwangjin Ahn, Dokyun Kim, Seok Hoon Jeong, Hyun Soo Kim, Young Ree Kim, Young Ah Kim, Kyeong Seob Shin, Jeong Hwan Shin, Jeong Su Park, Kyoung Un Park, Yong Jun Kwon, Soo Hyun Kim, Jong Hee Shin, Soon Young Ahn, Sung Young Lee, Song-Mee Bae, Jung Sik Yoo, Young Uh","doi":"10.3390/diagnostics16081240","DOIUrl":"10.3390/diagnostics16081240","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The Korean Global Antimicrobial Resistance Surveillance System monitors bloodstream <i>Staphylococcus aureus</i> infections by combining antimicrobial susceptibility testing (AST) with conventional polymerase chain reaction (PCR). Considering the clinical significance of methicillin-resistant <i>S. aureus</i> (MRSA), we performed an in-depth analysis of isolates showing genotypic-phenotypic discrepancies. <b>Methods</b>: Isolates were collected from designated collection centers in the Republic of Korea between 2017 and 2024. The 30 μg cefoxitin disk diffusion method was used to define the phenotypes. PCR targeting <i>mecA</i> and the staphylococcal cassette chromosome <i>mec</i> (SCC<i>mec</i>) was used to identify genotypes through gel electrophoresis. Long-read whole-genome sequencing (WGS) was performed using the Revio system (Pacific Biosciences) for isolates exhibiting discrepancies between phenotypes and genotypes. <b>Results</b>: In total, 5808 isolates were screened, and seven cases of genotypic-phenotypic discrepancies were identified, including one infant and six elderly patients with chromosomal SCC<i>mec</i> type IV. Although WGS confirmed intact PCR primer-binding sites, structural alterations were observed: three isolates had normal-length <i>mecA</i> and <i>mecR1</i>, two had partial deletions in <i>mecA</i>, and two featured either <i>mecA</i> or <i>mecR1</i> split into two proteins. Notably, although the six isolates with intact <i>mecR1</i> genes matched the nucleotide length of SCC<i>mec</i> type IV, their sequences exhibited high homology with SCC<i>mec</i> type II. <b>Conclusions</b>: Despite the presence of <i>mecA</i>, the non-standard configuration of regulatory genes within the SCC<i>mec</i> elements suppressed actual resistance expression. Because conventional PCR focusing on partial gene segments could overlook such phenotypic traits, the meticulous observation and implementation of WGS are crucial for the accurate characterization of genotypic-phenotypic discrepancies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812288","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":"From Neurological Severity to Anatomical Burden: An Integrated Clinical-CT Model for Predicting In-Hospital Mortality in Adults with Penetrating Cranial Gunshot Injuries.","authors":"Mustafa Emre Sarac, Zeki Boga, Ali Arslan, Ümit Kara, Mehmet Ozer, Ali Harmanoğullarından, Yurdal Gezercan","doi":"10.3390/diagnostics16081246","DOIUrl":"10.3390/diagnostics16081246","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cranial gunshot injuries represent severe traumatic brain injuries associated with high mortality rates. This study investigated whether integrating clinical findings at admission, including GCS score and pupillary response, with a CT-derived anatomical burden score and midline shift improves the prediction of in-hospital mortality. <b>Methods:</b> Adult patients aged 18 years and older with penetrating cranial gunshot injuries (<i>n</i> = 143) treated at a tertiary referral centre between 1 January 2005 and 31 December 2025 were retrospectively analysed using a single-centre cohort design. All included patients completed in-hospital follow-up, defined as hospital discharge or in-hospital death. Clinical variables, the anatomical burden score, and midline shift were evaluated using a multivariable logistic regression model where the primary outcome was in-hospital mortality. Model performance was assessed using ROC analysis, calibration measures, and bootstrap internal validation. <b>Results:</b> The in-hospital mortality rate was 56.6%, with early mortality occurring in 33.6% of patients. In the multivariable analysis, a low admission GCS score (≤8), bilateral non-reactive pupils, an increased anatomical burden score, and midline shift were independently associated with a higher risk of mortality. The model demonstrated good discrimination (AUC = 0.87; 95% CI 0.81-0.93), and similar performance was maintained following internal validation (optimism-corrected AUC = 0.86). The addition of radiological parameters to clinical variables improved model discrimination (ΔAUC = 0.07; 95% CI 0.02-0.11). <b>Conclusions:</b> The combined evaluation of admission clinical findings and CT-based anatomical parameters may support a more structured early estimation of in-hospital mortality risk in adult patients with penetrating cranial gunshot injuries.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811925","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":"Point-of-Care Diagnostic Technologies for Antimicrobial Resistance: Principles, Platforms, Clinical Impact, and Future Directions.","authors":"Nahed N Mahrous, Mohannad M Fallatah, Rawan A Fitaihi, Hala Aldahshan, Areej A Alhhazmi, Samiyah Al-Khaldi, Hussam Fallatah, Abdulmajeed A Althobaiti, Abdulaziz Saleh Alkhoshaiban, Jawaher Alguraini, Esraa A Aldkheil, Yahya F Jamous","doi":"10.3390/diagnostics16081239","DOIUrl":"10.3390/diagnostics16081239","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is an ever-growing threat to global healthcare. It is largely driven by delayed or inadequate pathogen identification and antimicrobial susceptibility testing in routine clinical workflows. By the time the clinician receives results to guide treatment from traditional culture-based diagnostics, several days may have elapsed, leading to the use and potential over-prescription of broad-spectrum antibiotics and the development of resistant pathogens. A rapid and clinically actionable diagnostic approach at the clinical point of care (POC) may help address this gap. This review examines current and emerging POC diagnostic technologies for AMR and outlines the fundamental principles and mechanistic classifications of POC diagnostic technologies. These include phenotypic, genotypic, immunological, and biosensor-based approaches. A critical overview of key technological platforms, including rapid phenotypic antimicrobial susceptibility testing (AST), microfluidics and isothermal nucleic acid amplification (e.g., LAMP and RPA), CRISPR-based diagnostics, nanomaterial-enhanced biosensors, and mobile-integrated systems is provided. The impact of POC diagnostics on antimicrobial stewardship, time to appropriate therapy, and patient outcomes in primary care settings, hospitals, intensive care units, and resource-limited settings is presented and discussed. In addition to clinical implementation challenges, this review considers the issues of analytical performance, workflow, regulatory pathways, cost, and implementation readiness. In addition, it outlines key trends regarding digital integration, surveillance, workforce training, and policy frameworks. Overall, the review outlines the role of POC diagnostics in enhancing antimicrobial response surveillance and the global fight against AMR. Among emerging platforms, rapid phenotypic AST, microfluidic and isothermal-based assays, CRISPR-based diagnostics, and integrated biosensor systems show the greatest potential for near-term clinical impact; however, widespread implementation remains constrained by challenges related to clinical validation, cost, workflow integration, and alignment with antimicrobial stewardship frameworks.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811978","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":"Phonosurgical Treatment of Laryngeal Leukoplakia and Dysplasia: Results of Multidimensional Voice Diagnostics Including the VEM.","authors":"Moonef Alotaibi, Felix Caffier, Ahmad S A Alghamdi, Carla Azar, Martin Kampmann, Tadeus Nawka, Dirk Mürbe, Philipp P Caffier","doi":"10.3390/diagnostics16081242","DOIUrl":"10.3390/diagnostics16081242","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Laryngeal leukoplakia and dysplasia carry a variable risk of malignant transformation. Although microlaryngoscopic excision is standard of care, data on voice function are limited. Multidimensional diagnostics, including the Vocal Extent Measure (VEM), were employed to assess pre- and postoperative status while identifying factors associated with vocal outcomes. <b>Methods</b>: This retrospective cohort included 44 patients with histologically confirmed vocal fold leukoplakia or dysplasia. All underwent cold steel or laser-assisted phonomicrosurgery. Voice assessments were conducted pre- and three months postoperatively, comprising videolaryngostroboscopy, auditory-perceptual evaluation of grade, roughness and breathiness (GRB), self-assessment (Voice Handicap Index, VHI-9i), and objective acoustic-aerodynamic measures. <b>Results</b>: Overall, 57% of patients were active smokers; 73% consumed alcohol. Lesions were mostly unilateral (77%), craniomedially localized (65%), and involved up to one-third of the vocal fold (48%), with impaired mucosal wave (76%). Histopathology revealed mainly hyperkeratosis (52%) and dysplasia (35%). Recurrence rate was 14%, with histology unchanged. Postoperatively, subjective measures showed significant improvements (post- vs. preoperative), with decreased VHI-9i scores (10 vs. 14) and GRB ratings (<i>p</i> < 0.05). Objective measures showed positive trends, including enhanced vocal capacity (VEM 85 vs. 82), stability (jitter 0.6 vs. 0.8%), and aerodynamics (maximum phonation time 18 vs. 15 s). Phonosurgical method, histopathology, and age did not significantly affect voice outcomes; however, higher dysplasia grades and younger age showed trends toward greater VEM gains. <b>Conclusions</b>: Phonomicrosurgical excision of laryngeal leukoplakia and dysplasia effectively preserves or enhances vocal function. The VEM provides a reliable, quantitative complement to established voice diagnostics and should be integrated into standardized assessment protocols.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811982","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":"Clinical Profiles and Prognostic Patterns in Critically Ill Cardiac Patients Requiring Invasive Mechanical Ventilation: A Five-Year Retrospective Cohort Study.","authors":"Liviu Macovei, Andreea Chiper, Daniel Dăscălescu, Cristian Stătescu, Grigore Tinică","doi":"10.3390/diagnostics16081237","DOIUrl":"10.3390/diagnostics16081237","url":null,"abstract":"<p><p><b>Background:</b> Critically ill cardiac patients who require invasive mechanical ventilation represent a high-risk population with persistently elevated in-hospital mortality, despite advances in cardiovascular and critical care management. Real-world data describing clinical profiles and prognostic patterns in this population remain limited. <b>Objectives:</b> The aim of this study was to characterize clinical profiles and prognostic patterns among critically ill cardiac patients requiring invasive mechanical ventilation and to identify variables associated with in-hospital mortality. <b>Methods:</b> We conducted a five-year retrospective observational cohort study, including 492 adult patients admitted to a tertiary cardiovascular intensive care unit who required invasive mechanical ventilation. The demographic characteristics, cardiovascular risk factors, primary cardiac diagnoses, major in-hospital complications, duration of mechanical ventilation, length of hospital stay, and in-hospital mortality were analyzed. <b>Results:</b> The overall in-hospital mortality was 53.9%. Acute myocardial infarction was the most frequent primary diagnosis. Advanced age, diabetes mellitus, cardiogenic shock, acute renal dysfunction, hepatic dysfunction and prolonged hospitalization were significantly associated with increased mortality (<i>p</i> < 0.05 for all comparisons). Cardiogenic shock showed the strongest association (<i>p</i> < 0.001). Ventilator-associated respiratory infections occurred in 16.9% of patients, and were associated with a prolonged hospital stay (<i>p</i> < 0.05), without a statistically significant association with mortality. <b>Conclusions:</b> Critically ill cardiac patients requiring invasive mechanical ventilation exhibit distinct high-risk clinical profiles characterized by advanced age, cardiogenic shock, metabolic comorbidities, and the development of multi-organ dysfunction. These findings highlight prognostic patterns that may support risk stratification and generate hypotheses for future prospective studies in cardiac intensive care.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 8","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811993","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}