Diagnostics最新文献

{"title":"Hyperreflective Dots on SD-OCT: Implications for Predicting Treatment Outcomes in Diabetic Macular Edema.","authors":"Siying Li, Muzi Li, Aimin Sun, Hongwei Zhang","doi":"10.3390/diagnostics15192539","DOIUrl":"10.3390/diagnostics15192539","url":null,"abstract":"<p><p><b>Objectives:</b> To evaluate the relationship between hyperreflective dots (HRDs) observed on spectral-domain optical coherence tomography (SD-OCT) and the outcomes following treatment with intravitreal ranibizumab or dexamethasone injections in patients with diabetic macular edema (DME). <b>Methods:</b> This retrospective study focused on individuals suffering from diabetic macular edema (DME) who underwent a sequence of three intravitreal ranibizumab injections. Based on treatment response, the eyes were categorized into two groups: responders and non-responders. The non-responder group subsequently received intravitreal dexamethasone (IVO) implants. Treatment results were evaluated by changes in BCVA, HRD number, and central macular thickness (CMT). <b>Results:</b> This research involved 112 eyes from 78 participants who had been diagnosed with DME. Seventy-three eyes (65%) were identified as ranibizumab responders and 39 eyes (35%) as ranibizumab non-responders. Of the 39 individuals who had suboptimal response to ranibizumab and subsequently received treatment with an intravitreal dexamethasone implant, 26 eyes (66.67%) exhibited a favorable response, while 13 eyes (33.33%) showed an insufficient response. IVR responders demonstrated significantly greater improvements in BCVA (0.54 ± 0.73 to 0.35 ± 0.40 logMAR vs. 0.52 ± 0.61 to 0.47 ± 0.38 logMAR) and CMT (456.53 ± 109.73 μm to 235.47 ± 49.13 μm vs. 468.99 ± 127.10 μm to 427.45 ± 52.91 μm) reduction. Baseline analysis revealed IVR non-responders had higher counts of both inner and outer retinal HRDs compared to responders (9.09 ± 3.38 vs. 7.07 ± 2.32 and 5.46 ± 2.03 vs. 4.27 ± 1.87, <i>p</i> < 0.05, respectively). Eyes with initially higher numbers of inner retinal HRDs, outer retinal HRDs, and subretinal HRDs demonstrated a significantly enhanced response to dexamethasone therapy (9.03 ± 3.18 vs. 7.55 ± 2.72, 6.55 ± 2.46 vs. 4.79 ± 1.88 and 0.27 ± 0.54 vs. 0.21 ± 0.47, <i>p</i> < 0.05, respectively). <b>Conclusions:</b> HRDs could potentially be used as a predictive biomarker to assess the effectiveness of anti-VEGF therapy in treating DME. Patients exhibiting a greater number of retinal HRDs tend to have less favorable reactions to anti-VEGF treatments but experience improved results with dexamethasone.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299130","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":"Factors Correlated with Post-Surgery Residual Carcinoma in Cases of Breast Cancer Incidentally Found via Vacuum-Assisted Excision: An Ultrasound Perspective.","authors":"Qiongchao Jiang, Simin Li, Guoxue Tang, Xiaofeng Guan, Wei Qin, Huan Wu, Haohu Wang, Xiaoyun Xiao","doi":"10.3390/diagnostics15192549","DOIUrl":"10.3390/diagnostics15192549","url":null,"abstract":"<p><p><b>Objectives</b>: To identify factors correlated with post-surgery residue in cases of breast cancer incidentally found via vacuum-assisted excision (VAE). <b>Methods</b>: A total of 6083 patients were enrolled in a retrospective study. Ultrasound evaluation and ultrasound-guided VAE were performed on these patients. According to the pathology of VAE, 53 patients with incidentally found breast cancer were included in the final analysis. Either breast-conserving surgery or mastectomy was performed. The maximal diameter, depth, location, BIRADS category, and Adler's grade of all lesions before VAE was reviewed and recorded. VAE and post-surgery pathologies were used as gold standards. Either Pearson's chi-square test or Fisher's exact test was used for comparison of categorical variables. <b>Results</b>: The mean age of the enrolled patients was 49 years (IQR: 43-55 years). The mean maximal diameter of the lesions was 11.3 mm (IQR: 7-15 mm). There were twenty-eight ductal carcinomas in situ, twelve invasive ductal carcinomas, five lobular carcinomas in situ, two invasive lobular carcinomas, four intraductal papillary carcinomas, and two mucinous carcinomas. Post-surgery pathology showed 15 cases with residual cancer and 38 cases with no residual cancer. The maximal diameter, depth, and pathology derived via VAE were statistically correlated with post-surgery residue (<i>p</i> < 0.05). <b>Conclusions</b>: Small incidentally found noninvasive carcinomas located comparatively deep in the breast could be totally excised by ultrasound-guided vacuum-assisted excision. Both large and superficially invasive carcinomas were more likely to be associated with residue.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299139","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":"Incidence, Clinical Profile, and Cardiac Manifestations of MIS-C in Children in Kuwait.","authors":"Ozayr Mahomed, Adnan Alhadlaq, Khaled Alsaeid, Aisha Alsaqabi, Fouzeyah Othman, Saja Al-Shammari, Sarah Al-Yaqoub, Abdullah Al-Daihani, Abdulla Alfraij, Khalid Alafasy, Mafaza Al-Qallaf, Mariam Al-Hajeri, Nora Al-Mutairi, Alaa Alenezi, Shaimaa Mohammed, Adnan Al-Sarraf, Dalia Al-Abdulrazzaq, Hessa Al-Kandari","doi":"10.3390/diagnostics15192545","DOIUrl":"10.3390/diagnostics15192545","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Multisystem inflammatory syndrome in children (MIS-C), a rare but serious post-acute hyperinflammatory condition that occurs in children 2-6 weeks after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection or exposure, varies between countries. Despite its serious nature, most children recover without any sequelae. The most frequently reported long-term sequelae are coronary artery aneurysms. This study aimed to describe the epidemiological profile, clinical characteristics (including cardiac manifestations), treatment, and outcomes of multisystem inflammatory syndrome in children (MIS-C) under 14 years of age with SARS-CoV-2 between February 2020 and November 2021 in Kuwait. <b>Methods</b>: Data on sociodemographic factors, co-morbidities, presenting signs and symptoms, as well as laboratory and echocardiography findings were retrieved from the Pediatric COVID registry (PCR-Q8 registry). <b>Results</b>: Of the one hundred and two patients with a provisional diagnosis of MIS-C, eighty-three patients fulfilled the WHO criteria of MIS-C. Thirty-nine of the MIS-C patients were admitted to the intensive care unit, and only one child died due to cardiogenic shock. Sixteen patients from the pediatric MIS-C cohort were diagnosed with cardiac abnormalities. Sixteen patients from the pediatric MIS-C cohort were diagnosed with cardiac abnormalities. Most (63% (10/16)) of the patients had coronary abnormalities, nine patients (56%) had myocardial dysfunction, and six patients (38%) had dual pathologies. Pericarditis occurred in three patients only, whilst six patients (38%) had dual pathologies. Pericarditis occurred in three patients only. <b>Conclusions</b>: MIS-C appears to affect younger children in Kuwait than in other countries; however, the clinical pattern is consistent with other countries. Further studies of an analytical nature are recommended to identify the risk factors associated with MIS-C and its cardiac sequalae to allow for proactive risk reduction.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299146","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":"Differences in Vaginal Microbiota Composition Between Infertile and Fertile Patients: A Prospective Study.","authors":"Pei-Chen Chen, Shih-Fen Chen, Wei-Tung Hung, Yu-Ying Lin, Ling-Chun Lin, Jen-Hung Wang, Pao-Chu Chen","doi":"10.3390/diagnostics15192544","DOIUrl":"10.3390/diagnostics15192544","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dysbiosis of the vaginal microbiota, particularly the loss of Lactobacillus spp. dominance, is linked to female infertility. While community state types (CSTs) I-III and V have been studied extensively, CST IV remains underexplored. The aim of this prospective study was to compare vaginal microbiota composition-specifically CST IVA and IVB-between fertile and infertile women. <b>Methods</b>: Vaginal samples were collected from 22 women (15 infertile, 7 fertile) using cervical brushes and analyzed via 16S rRNA gene sequencing. DNA was extracted, and V3-V4 regions were sequenced using the Illumina MiSeq platform. Taxonomic classification was performed with QIIME 2 and the Greengenes database. Differences in microbial composition were assessed using the Wilcoxon rank-sum test (<i>p</i> < 0.05) in SPSS v21.0. <b>Results</b>: Infertile women showed lower relative abundances of <i>Lactobacillus</i> spp. (31.54% vs. 42.32%) and <i>Oscillospira</i> spp. relative to fertile women. CST IV was more frequent in the infertile group (29.75% vs. 21.61%). Within CST IV, CST IVA accounted for a higher proportion in infertile women (7.0% vs. 0.94%), with <i>Prevotella</i> spp. representing 95.18% of CST IVA in infertile subjects, as opposed to the figure of 69.77% in fertile counterparts. No clear differences in CST IVB were observed between groups. <b>Conclusions</b>: Increased prevalence of <i>Prevotella</i> spp. in CST IVA may contribute to an unfavorable vaginal environment in infertile women, potentially affecting sperm viability. The presence of <i>Oscillospira</i> spp. in fertile women suggests it is associated with a healthy vaginal microbiota profile.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298864","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":"Apparent Diffusion Coefficient as a Predictor of Microwave Ablation Response in Thyroid Nodules: A Prospective Study.","authors":"Mustafa Demir, Yunus Yasar","doi":"10.3390/diagnostics15192538","DOIUrl":"10.3390/diagnostics15192538","url":null,"abstract":"<p><p><b>Background:</b> Microwave ablation (MWA) is an effective, minimally invasive therapy for benign thyroid nodules; however, the treatment response varies considerably. Identifying imaging biomarkers that can predict volumetric outcomes may optimize patient selection. Diffusion-weighted MRI (DW-MRI) offers a noninvasive assessment of tissue microstructure through apparent diffusion coefficient (ADC) measurements, which may correlate with ablation efficacy. <b>Methods:</b> In this prospective study, 48 patients with 50 cytologically confirmed benign thyroid nodules underwent diffusion-weighted magnetic resonance imaging (DW-MRI) before minimally invasive ablation (MWA). Baseline ADC values were measured, and nodule volumes were assessed by ultrasound at baseline and 1, 3, and 6 months postprocedure. The volume reduction ratio (VRR) was calculated, and associations with baseline variables were analyzed via Pearson correlation and multivariable linear regression. ROC curve analysis was used to evaluate the diagnostic performance of ADC in predicting significant volume reduction (VRR ≥ 50%). <b>Results:</b> Lower baseline ADC values were strongly correlated with greater VRR at 3 months (r = -0.525, <i>p</i> < 0.001) and 6 months (r = -0.564, <i>p</i> < 0.001). Multivariable regression revealed that the baseline ADC was the sole independent predictor of the 6-month VRR (β = -19.52, <i>p</i> = 0.0004). ROC analysis demonstrated excellent discriminative performance (AUC = 0.915; 95% CI: 0.847-0.971), with an ADC cutoff of 2.20 × 10^-3 mm²/s yielding 90.9% sensitivity and 83.3% specificity for predicting a favorable volumetric response. <b>Conclusions:</b> Baseline ADC values derived from DW-MRI strongly predict volumetric response following microwave ablation of benign thyroid nodules. Incorporating ADC assessment into preprocedural evaluation may enhance patient selection and improve therapeutic outcomes.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299000","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 Account of Acute Myeloid Leukemia Complicating Pregnancy and Literature Review.","authors":"Georgiana Nemeti, Laura Jimbu, Oana Mesaros, Iulian Gabriel Goidescu, Cezara Moisa, Mihai Surcel, Cerasela Mihaela Goidescu, Dan Boitor-Borza, Gheorghe Cruciat, Ioana Cristina Rotar, Daniel Muresan","doi":"10.3390/diagnostics15192540","DOIUrl":"10.3390/diagnostics15192540","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> The occurrence of acute myeloid leukemia (AML) in pregnancy represents a diagnostic and management challenge in the attempt to balance and achieve both maternal and fetal wellbeing. Pregnancy-specific manifestations mimic the initial symptoms of leukemia and may lead to a delay in diagnosis, especially during the first trimester of pregnancy. Decision-making strategies involve the patient and couples counseling with a multidisciplinary team of hematologists, obstetricians, neonatologists and psychologists. Maternal outcome depends on the disease subtype, progression and response to medication. Fetal outcome depends on other potential pregnancy complications, possible teratogenicity, gestational age at delivery and sometimes iatrogenic prematurity. <b>Case Presentation:</b> We present the case of a 38-year-old multiparous patient with a late first trimester, with an AML diagnosis presenting with hyperemesis gravidarum-like symptoms. Genetic testing revealed the presence of an Fms-like tyrosine kinase 3-internal tandem duplication mutation (FLT3-ITD). Following that, a repeatedly refused termination of pregnancy and rapid disease progression with azacitidine therapy was initiated. Elective cesarean delivery was performed at 34 weeks of gestation due to progressive leukocytosis, which persisted postpartum, requiring the use of first-, second-, and eventually third-line chemotherapy. Fetal outcome was favorable at 3 months postpartum. <b>Conclusions:</b> Cases of AML in pregnancy require a tailored approach according to guidelines, but also patient/couple preferences, while the choice of chemotherapy is limited considering its potential teratogenic effects. This is a case with a misleading first presentation and a challenging therapeutic choice due to its genetic subtype and maternal treatment postponement.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299027","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":"Exploring AI's Potential in Papilledema Diagnosis to Support Dermatological Treatment Decisions in Rural Healthcare.","authors":"Jonathan Shapiro, Mor Atlas, Naomi Fridman, Itay Cohen, Ziad Khamaysi, Mahdi Awwad, Naomi Silverstein, Tom Kozlovsky, Idit Maharshak","doi":"10.3390/diagnostics15192547","DOIUrl":"10.3390/diagnostics15192547","url":null,"abstract":"<p><p><b>Background</b>: Papilledema, an ophthalmic finding associated with increased intracranial pressure, is often induced by dermatological medications, including corticosteroids, isotretinoin, and tetracyclines. Early detection is crucial for preventing irreversible optic nerve damage, but access to ophthalmologic expertise is often limited in rural settings. Artificial intelligence (AI) may enable the automated and accurate detection of papilledema from fundus images, thereby supporting timely diagnosis and management. <b>Objective</b>: The primary objective of this study was to explore the diagnostic capability of ChatGPT-4o, a general large language model with multimodal input, in identifying papilledema from fundus photographs. For context, its performance was compared with a ResNet-based convolutional neural network (CNN) specifically fine-tuned for ophthalmic imaging, as well as with the assessments of two human ophthalmologists. The focus was on applications relevant to dermatological care in resource-limited environments. <b>Methods</b>: A dataset of 1094 fundus images (295 papilledema, 799 normal) was preprocessed and partitioned into a training set and a test set. The ResNet model was fine-tuned using discriminative learning rates and a one-cycle learning rate policy. GPT-4o and two human evaluators (a senior ophthalmologist and an ophthalmology resident) independently assessed the test images. Diagnostic metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and Cohen's Kappa, were calculated for each evaluator. <b>Results</b>: GPT-4o, when applied to papilledema detection, achieved an overall accuracy of 85.9% with substantial agreement beyond chance (Cohen's Kappa = 0.72), but lower specificity (78.9%) and positive predictive value (73.7%) compared to benchmark models. For context, the ResNet model, fine-tuned for ophthalmic imaging, reached near-perfect accuracy (99.5%, Kappa = 0.99), while two human ophthalmologists achieved accuracies of 96.0% (Kappa ≈ 0.92). <b>Conclusions</b>: This study explored the capability of GPT-4o, a large language model with multimodal input, for detecting papilledema from fundus photographs. GPT-4o achieved moderate diagnostic accuracy and substantial agreement with the ground truth, but it underperformed compared to both a domain-specific ResNet model and human ophthalmologists. These findings underscore the distinction between generalist large language models and specialized diagnostic AI: while GPT-4o is not optimized for ophthalmic imaging, its accessibility, adaptability, and rapid evolution highlight its potential as a future adjunct in clinical screening, particularly in underserved settings. These findings also underscore the need for validation on external datasets and real-world clinical environments before such tools can be broadly implemented.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299108","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":"Prognostic Insights into Orbital Metastases: A Comprehensive Analysis of Clinical Features and Survival Outcomes.","authors":"Burak Ulas, Altan Atakan Ozcan, Feyza Alara Celikten, Omer Kaya, Ertugrul Bayram","doi":"10.3390/diagnostics15192542","DOIUrl":"10.3390/diagnostics15192542","url":null,"abstract":"<p><p><b>Background/Objectives:</b> We aimed to evaluate the demographic characteristics, clinical findings, and survival outcomes of patients diagnosed with orbital metastasis, considering primary tumor type, age, and gender variables. <b>Methods:</b> In this observational study, demographic data, tumor localization, histopathological diagnoses, and survival times of 83 patients followed for secondary orbital metastasis at Çukurova University Ophthalmology Department between 2003 and 2023 were retrospectively reviewed. Subgroup analyses were performed according to age (<18 and ≥19), gender, and primary tumor groups. <b>Results:</b> The study included 83 patients (51 (61.4%) females and 32 (38.6%) males). The mean age at diagnosis was found to be 40.8 ± 24.6 years. A total of 24.1% of the cases were in the pediatric age group (mean age 5.9 years), and the most common tumor metastasizing to the orbit in this group was neuroblastoma (80%). In adult patients, the two most frequent tumors metastasizing to the orbit were breast cancer (33.3%) and lung cancer (14.3%). The most common clinical findings were proptosis (32.5%) and blurred vision (26.2%). Orbital metastases were observed more frequently in females than in males (61.4% vs. 38.6%). This ratio was similar in the pediatric age group (65.0% vs. 35.0%). The mean survival time after metastasis was calculated as 316.7 ± 68.6 days. Female patients had a significantly longer survival time after metastasis compared to males (mean 400.4 vs. 165.4 days; <i>p</i> = 0.037). The median survival after metastasis was 86 days for patients with breast cancer and 204 days for patients with neuroblastoma. <b>Conclusions:</b> The most common source of orbital metastases in females is breast cancer, while neuroblastoma is prominent in pediatric patients. Despite all available treatment options, the prognosis after orbital metastasis is poor; this highlights the importance of early diagnosis and a multidisciplinary approach.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299133","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":"Influence of Scleral Contact Lenses on Optical Coherence Tomography Parameters in Keratoconus Patients.","authors":"Atılım Armağan Demirtaş, Aytül Arslan, Berna Yüce, Tuncay Küsbeci","doi":"10.3390/diagnostics15192541","DOIUrl":"10.3390/diagnostics15192541","url":null,"abstract":"<p><p><b>Background</b>: This study aimed to evaluate the influence of scleral contact lens (SCL) wear on optical coherence tomography (OCT) scan quality and structural measurements in patients with keratoconus. <b>Methods</b>: This retrospective observational study included 28 eyes of 28 keratoconus patients. All participants underwent a comprehensive ophthalmologic evaluation, including corneal topography and spectral-domain OCT (Optopol REVO 60). Two OCT measurement sessions were performed on the same day: one without SCLs and one after a 30-75 min adaptation period with Mini Misa^® scleral lenses. Recorded parameters included corneal and epithelial thicknesses, ganglion cell-inner plexiform layer (GCIPL) thickness, retinal nerve fiber layer (RNFL) thickness, and device-reported quality index (QI). Correlation analyses between topographic values, age, and OCT parameters were also conducted. <b>Results</b>: The mean age of participants was 32.96 ± 13.72 years. SCL wear significantly decreased anterior segment QI (6.76 ± 1.73 vs. 5.57 ± 2.34, <i>p</i> = 0.019) but improved posterior segment QI in both the ganglion (2.52 ± 1.03 vs. 5.76 ± 2.17, <i>p</i> < 0.001) and disc (2.82 ± 0.94 vs. 4.39 ± 1.87, <i>p</i> < 0.001) modules. Central corneal thickness remained stable, while central epithelial thickness decreased slightly (50.53 ± 6.66 µm vs. 47.59 ± 7.20 µm, <i>p</i> = 0.007). RNFL and GCIPL thicknesses showed no significant changes, except for minor sectoral variations. Steeper keratometry values correlated with lower QI in both conditions. <b>Conclusions</b>: SCLs enhanced posterior OCT scan quality while reducing anterior segment image clarity. These findings suggest that SCLs not only provide visual rehabilitation but also facilitate more reliable posterior segment imaging in keratoconus patients, despite mild interference with anterior segment OCT metrics. Further prospective studies are warranted to validate these results.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299159","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":"Salivary Molecular Testing for Periodontal Pathogen Monitoring: Clinical Performance of Flexible RT-PCR Platforms in Preventive Care Settings.","authors":"Fabiana D'Urso, Federica Paladini, Mauro Pollini, Francesco Broccolo","doi":"10.3390/diagnostics15192548","DOIUrl":"10.3390/diagnostics15192548","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to validate the clinical utility of a salivary molecular platform (Oral Predict^®) for periodontal pathogen detection across preventive, therapeutic, and maintenance settings. <b>Methods:</b> A longitudinal randomized study was conducted involving 78 adults who provided saliva samples at baseline, one month, and three months after professional dental hygiene. Participants were randomized into two groups: control group (n = 39) and probiotic group with Oral Predict^® probiotic supplementation (n = 39). Crude saliva was processed directly without nucleic acid extraction and analyzed by multiplex real-time PCR using either the compact Real-time PCR system or standard thermocyclers. <b>Results:</b> At baseline, <i>Fusobacterium nucleatum</i> was the most prevalent pathogen (84.6%), followed by <i>Tannerella forsythia</i> (53.8%) and <i>Porphyromonas</i> gingivalis (46.2%). The Total Pathogen Burden Score (TPBS) showed progressive increases with age, smoking, and poor oral hygiene, and was significantly higher in participants with gingival bleeding. Among individual pathogens, no significant associations were observed with periodontitis staging or grading. Professional hygiene induced mean reductions of 1-2 logs across all pathogens, with TPBS decreasing from 8.7 ± 3.2 to 4.1 ± 2.8 (<i>p</i> < 0.001). At three months, 69.2% of the control group experienced bacterial rebound, whereas 85% of probiotic users sustained or improved bacterial reductions. <b>Conclusions</b>: Salivary molecular testing provides a robust, non-invasive approach for periodontal pathogen detection, treatment monitoring, and long-term maintenance assessment. The flexibility of the Oral Predict^® platform across point-of-care and laboratory settings, combined with automated interpretation, supports integration into preventive protocols and personalized periodontal care. These findings demonstrate the potential of saliva-based molecular diagnostics to shift periodontal management from reactive to predictive and precision-based strategies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 19","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299251","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}