Diagnostics最新文献

{"title":"Clinical Yield of Colonoscopy in Evaluation of Young Women with Constipation: An Age- and Gender-Based Analysis.","authors":"Amani Beshara, Avraham Yitzhak, Revital Guterman, Ruhama Elhayany, Majd Khader, Sarah Weissmann, Naim Abu-Freha","doi":"10.3390/diagnostics15101209","DOIUrl":"10.3390/diagnostics15101209","url":null,"abstract":"<p><p><b>Background:</b> Constipation is one of the most common gastrointestinal complaints among women, with a variety of contributing factors. We aimed to assess the role of colonoscopy in evaluating young women with constipation. <b>Methods:</b> A multi-center, large cohort, retrospective study included all data from colonoscopies performed between 2016 and 2023 in seven endoscopy departments. The indications and findings of the procedures were collected, and findings of young women aged ≤40 y with constipation as an indication were compared to older women and men of the same age groups. <b>Results:</b> The cohort comprised 377,795 patients, including 198,629 (52.6%) females and 179,166 (47.4%) males. In total, 7872 females underwent colonoscopy for constipation and other indications <b>(Cohort 1)</b>. In addition, 6852 women were referred for a colonoscopy for constipation only <b>(Cohort 2)</b>. In sum, 75% of colonoscopies in women <40 y were normal in both cohorts. In <b>Cohort 1,</b> inflammatory bowel diseases (IBD) were significantly higher in women <40 y with Ulcerative Colitis (UC) (1.2%) and Crohn's disease (CD) (0.7%), <i>p</i> < 0.001). The rate of IBD was lower but still significant in <b>Cohort 2</b>. In both cohorts, diverticulosis and polyp rates exponentially increased with age >40 y, <i>p</i> < 0.001. Higher rates of diverticulosis and polyps were found among males <40 y in <b>Cohort 1.</b> One case (0.1%) of Colorectal cancer (CRC) was found in <40 y women. Similar IBD and CRC rates were found in males and females of all ages, <i>p</i> > 0.05. <b>Conclusions:</b> The diagnostic yield of colonoscopy for investigating isolated constipation in young females is not significant. Diagnostic work-up should be guided by accurate clinical understanding.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157287","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":"Positive Association Between Ultrasonographic Fatty Liver Indicator and the Severity of Coronary Artery Disease.","authors":"Tingqiu Wang, Zhigang Wang, Peng Luo","doi":"10.3390/diagnostics15101208","DOIUrl":"10.3390/diagnostics15101208","url":null,"abstract":"<p><p><b>Background</b>: This study investigates the link between metabolic dysfunction-associated fatty liver disease (MAFLD) and coronary artery disease (CAD) using the ultrasonographic fatty liver indicator (US-FLI) to assess liver steatosis. <b>Methods</b>: A total of 204 patients were included, with hepatic steatosis evaluated through ultrasound characteristics, diagnosing fatty liver when US-FLI was ≥2. CAD severity was determined using the SYNTAX score (SS), categorizing 100 CAD patients into mild (SS ≤ 22) and moderate-severe (MS) (SS ≥ 23) groups. The association between US-FLI and SS in patients with MAFLD was evaluated through the multivariate logistic regression model. A receiver operating characteristic curve was applied to determine the accuracy, sensitivity, and specificity of US-FLI in predicting SS. <b>Results</b>: In the multivariate logistic regression analysis, US-FLI was an independent predictor of the CAD group (OR = 1.194, 95% CI: 1.008-1.414, <i>p</i> = 0.040) and the MS group (OR = 1.262, 95% CI: 1.025-1.553, <i>p</i> = 0.028). In the receiver operating characteristic curve analysis, a US-FLI value of 2 was found to be the optimal threshold point for diagnosing MS CAD patients (AUC = 0.620, 95% CI: 0.509-0.713, <i>p</i> = 0.039), with a sensitivity of 65.22% and a specificity of 55.56%. The diagnostic performance of MS CAD patients significantly improved when US-FLI was combined with type 2 diabetes mellitus (T2DM) (AUC = 0.732, 95% CI: 0.632-0.832, <i>p</i> < 0.001), with a sensitivity of 65.22% and specificity of 77.78%. <b>Conclusions</b>: US-FLI was independently and positively associated with CAD severity. US-FLI combined with T2DM had better diagnostic performance in patients with MS CAD.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157339","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":"Atrial Cardiomyopathy in Atrial Fibrillation: A Multimodal Diagnostic Framework.","authors":"Paschalis Karakasis, Panayotis K Vlachakis, Panagiotis Theofilis, Nikolaos Ktenopoulos, Dimitrios Patoulias, Barbara Fyntanidou, Antonios P Antoniadis, Nikolaos Fragakis","doi":"10.3390/diagnostics15101207","DOIUrl":"10.3390/diagnostics15101207","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is increasingly recognized as the clinical manifestation of an underlying atrial disease process rather than a purely electrical disorder. This evolving paradigm has given rise to the concept of atrial cardiomyopathy (AtCM), encompassing structural, electrical, contractile, and molecular remodeling of the atrial myocardium that contributes to AF initiation, maintenance, and progression. Although consensus definitions of AtCM now exist, its integration into clinical practice remains limited, with AF management still largely guided by arrhythmic patterns rather than substrate characterization. This review synthesizes current diagnostic strategies for AtCM within the context of AF, emphasizing a multimodal approach. We outline advances in cardiac imaging-including echocardiography, cardiac magnetic resonance, and computed tomography-for detailed assessment of atrial morphology, function, and fibrosis. Electroanatomic mapping is discussed as a key invasive tool for substrate localization, while electrocardiographic indices such as P-wave morphology and dispersion serve as accessible surrogates of electrical remodeling. In parallel, we examine the role of circulating biomarkers and emerging genomic, transcriptomic, and epigenomic markers in refining disease phenotyping. Despite promising progress, significant challenges remain. Standardization of imaging protocols, validation of biomarker thresholds, and integration of artificial intelligence tools are needed to enhance clinical utility. A diagnostic framework informed by atrial substrate assessment may support more tailored therapeutic decision-making in AF. Future research should prioritize the harmonization of diagnostic criteria and explore how substrate profiling in AF may refine risk stratification and improve clinical outcomes.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157273","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":"Is a 3-Minute Knee MRI Protocol Sufficient for Daily Clinical Practice? A SuperResolution Reconstruction Approach Using AI and Compressed Sensing.","authors":"Robert Hahnfeldt, Robert Terzis, Thomas Dratsch, Lajos Maximilian Basten, Philip Rauen, Johannes Oppermann, David Grevenstein, Jan Paul Janßen, Nour El-Hoda Abou Zeid, Kristina Sonnabend, Christoph Katemann, Stephan Skornitzke, David Maintz, Jonathan Kottlors, Grischa Bratke, Andra-Iza Iuga","doi":"10.3390/diagnostics15101206","DOIUrl":"10.3390/diagnostics15101206","url":null,"abstract":"<p><p><b>Objectives:</b> The purpose of this study was to assess whether a 3-min 2D knee protocol can meet the needs for clinical application if using a SuperResolution reconstruction approach. <b>Methods:</b> In this prospective study, a total of 20 volunteers underwent imaging of the knee using a 3T MRI scanner (Philips Ingenia Elition X 3.0T, Philips). The imaging protocol, consisting of a fat-saturated 2D proton density sequence in coronal, sagittal, and transverse orientations, as well as a sagittal T1-weighted sequence, was acquired with standard and ultra-low resolution. The standard sequences were reconstructed using an AI-assisted Compressed SENSE method (SmartSpeed). The ultra-low-resolution sequences have been reconstructed using a vendor-provided prototype. Four experienced readers (two radiologists and two orthopedic surgeons) evaluated the sequences for image quality, anatomical structures, and incidental pathologies. The consensus evaluation of two different experienced radiologists specialized in musculoskeletal imaging served as the gold standard. <b>Results:</b> The acquisition time for the entire protocol was 11:01 min for standard resolution and 03:36 min for ultra-low resolution. In the overall assessment, CS-SuperRes-reconstructed sequences showed slightly improved accuracy and increased specificity compared to the standard CS-AI method (0.87 vs. 0.86 and 0.9 vs. 0.87, respectively), while the standard method exhibited a higher sensitivity (0.73 vs. 0.57). Overall, 24 out of 40 pathologies were detected in the ultra-low-resolution images compared to 26 in the standard images. <b>Conclusions:</b> The CS-SuperRes method enables a 2D knee protocol to be completed in 3 min, with improved accuracy compared to the clinical standard.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157384","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":"Early Dynamics of Circulating Tumor DNA Following Curative Hypofractionated Radiotherapy Related to Disease Control in Lung Cancer.","authors":"Kyungmi Yang, Jae Myoung Noh, Yeon Jeong Kim, Hongryull Pyo","doi":"10.3390/diagnostics15101198","DOIUrl":"10.3390/diagnostics15101198","url":null,"abstract":"<p><p><b>Background/objectives:</b> We aimed to characterize the dynamic pattern of circulating tumor DNA (ctDNA) during hypofractionated radiation therapy (RT) in patients with lung cancer and assess its clinical relevance. <b>Metholds:</b> Prospectively, 24 patients diagnosed with early-stage lung cancer underwent curative RT with 60-64 Gy in 4-20 fractions. Blood samples were collected at baseline (D0) and on post-RT days 1-3 and 7 (D1-3 and D7). The ctDNA was longitudinally analyzed using LiquidSCAN. To find a feasible index associated with outcome, total VAF(%), max VAF(%), total GE (hGE/mL) and max GE (hGE/mL), were evaluated. <b>Results:</b> Thirteen patients with available samples were analyzed with a median 22.2-month follow-up (range, 5.2-34.3 months). Four patients experienced progression between 7.9 and 16.6 months after RT (PD group), and the nine presented no evidence of disease (NED group). The Dmax, the day with the highest ctDNA level among D0-7, was significantly different between the groups with total GE and max GE (<i>p</i> = 0.035 and 0.021, respectively). According to the ROC curves, the max GE showed the best AUC (86.1%) and the cut-off value of the Dmax was 1.5 (sensitivity: 66.7%, specificity: 100%, positive-predictive value: 100%, and negative-predictive value: 57.1%). Tumor size ≥ 3 cm, squamous histology, and a daily dose 3-4 Gy were correlated with the Dmax = D2-3. The Dmax showed better disease control rate with marginal significance (<i>p</i> = 0.081). <b>Conclusions:</b> The timing of early ctDNA elevation may have the potential to predict RT response. The max GE may be an index to verify the ctDNA levels after RT.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156692","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":"Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study.","authors":"Gabriel Viana Silva, Carolina Toledo Gontijo, Ana Paola Cruz Lunguinho, Mário Sérgio Gomes Caetano, Gustavo Yano Callado, Edward Araujo Júnior, Alberto Borges Peixoto","doi":"10.3390/diagnostics15101197","DOIUrl":"10.3390/diagnostics15101197","url":null,"abstract":"<p><p><b>Objective</b>: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. <b>Methods</b>: This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC. Singleton pregnancies ≥ 37 weeks were included, excluding fetal malformations, chromosomal anomalies, and cases with missing data and cord blood gas. <b>Results</b>: Of the 3364 medical records analyzed, 466 were included-366 without and 100 with an NC. Among the cases with an NC, 91% had one loop and 9% had ≥ two loops; 82% were loose and 18% were tight. Pregnant women with an NC had a higher gestational age (39.7 vs. 39.1 weeks, <i>p</i> = 0.006), fewer deliveries (1.0 vs. 2.0, <i>p</i> = 0.035), and a higher prevalence of cesarean sections (99% vs. 60.4%, <i>p</i> < 0.001). An NC was associated with a lower Apgar score at the 1st minute (8 vs. 9, <i>p</i> = 0.014) and higher arterial cord blood pH (7.27 vs. 7.24, <i>p</i> = 0.020). The presence of a tight cord was significantly associated with a 7.52-fold increased risk of an Apgar score < 7 at the 1st minute [x²(1) = 5.92, OR: 7.52, 95% CI: 1.51-37.31, R² Nagelkerke: 0.14, <i>p</i> = 0.014]. <b>Conclusions</b>: There was no effect of the presence of an NC on adverse perinatal outcomes. However, the presence of a tight NC was associated with an increased risk of an Apgar score < 7 at the 1st minute, but no other effect on neonatal outcomes.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157338","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":"The Potential Morphological Stenosis Pattern of the Arcuate Foramen.","authors":"Ioannis Paschopoulos, Maria Piagkou, George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Fabrice Duparc, Fotis Demetriou, George Tsakotos, Rǎzvan-Costin Tudose, Mugurel Constantin Rusu, Oana Daniela Toader","doi":"10.3390/diagnostics15101203","DOIUrl":"10.3390/diagnostics15101203","url":null,"abstract":"<p><p><b>Background</b>: The arcuate foramen (AF), an osseous foramen, is probably formatted from the ossification of the posterior atlanto-occipital membrane. When this morphologically ossified variant exists, it encloses the vertebral artery (VA) third segment (V3). This close relationship may cause compression to the VA with concomitant vertebrobasilar insufficiency, vertigo, headaches, or neck pain. In the published literature, no studies investigate the abovementioned potential compression pattern. The present study examines the AF ossification pattern (complete or partial type) and the variable VA diameter at the atlantal part (V3), concluding a potential risk for VA compression after correlating the relative diameters (AF and VA diameters). <b>Materials and Methods</b>: One hundred and fifty dried first cervical vertebrae (atlases) and one hundred fifty computed tomography (CT) scans were obtained for the present study. The presence of a complete or incomplete AF was evaluated, and when present, its diameter was measured. To correlate these findings with the vessel, 50 computed tomography angiographies (without AF presence) were obtained to measure the V3 segment diameter. <b>Results</b>: Out of the total 600 (<i>N</i> = 600) sides, 111 sides had incomplete AF (18.2%), and 67 sides had complete AF (11.1%). The AF mean diameter was 6.41 (1.12) mm. The diameter of the V3 segment ranged between 5.0 and 6.0 mm; therefore, three morphological stenosis patterns were identified. A low risk of compression (over 6.0 mm) was identified in 61.2% (<i>N</i> = 109 sides), a moderate risk (between 5.0-6.0 mm) was observed in 29.2% (<i>N</i> = 52 sides), and a high risk (under 5.0 mm) was recorded in 9.6% (<i>N</i> = 17 sides). There was no statistically significant correlation regarding sexes and age for the potential compression patterns. <b>Conclusions</b>: The present study revealed the morphological stenosis pattern of the AF to the V3 segment. The variation had a high risk of compression to the vessel in 9.6% of sides, indicating that it is not infrequent. Knowledge of these details is essential for clinicians when investigating vertebrobasilar insufficiency.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157353","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":"Evaluation of Retinal and Optic Nerve Parameters in Recovered COVID-19 Patients: Potential Neurodegenerative Impact on the Ganglion Cell Layer.","authors":"Muhammet Kaim, Muhammet Bahattin Kır, Feyzahan Uzun, Hüseyin Findik","doi":"10.3390/diagnostics15101195","DOIUrl":"10.3390/diagnostics15101195","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This study aimed to analyze optic nerve parameters, retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and subfoveal choroidal thickness (ChT) in patients who have recovered from coronavirus disease 2019 (COVID-19). <b>Methods:</b> This comparative study included 78 recovered COVID-19 patients (16 men, 62 women) and 56 age- and sex-matched healthy controls (18 men, 38 women). COVID-19 was confirmed in all patients, either through the detection of viral RNA in nasopharyngeal swabs via reverse transcriptase polymerase chain reaction or by serological testing for SARS-CoV-2 antibodies. Spectral-domain optical coherence tomography (SD-OCT) was used to assess optic nerve parameters, RNFLT, GCLT, and ChT. <b>Results:</b> The mean age was 35.0 ± 8.3 years in the COVID-19 group and 31.5 ± 8.3 years in the control group, with no statistically significant differences in age or sex distribution between groups (<i>p</i> = 0.41 and <i>p</i> = 0.16, respectively). Optic nerve parameters and RNFLT (overall and across the four peripapillary quadrants) did not differ significantly between the COVID-19 and control groups. However, the mean ganglion cell-inner plexiform layer (GC-IPL) thickness was significantly reduced in all quadrants in the COVID-19 group compared to the controls. No significant difference was observed in mean subfoveal ChT between groups. <b>Conclusions:</b> A significant reduction in ganglion GCLT was observed in recovered COVID-19 patients compared to healthy controls, suggesting a potential neurodegenerative effect of the disease on the optic nerve.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157300","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":"Advancing Meibography Assessment and Automated Meibomian Gland Detection Using Gray Value Profiles.","authors":"Riccardo Forni, Ida Maruotto, Anna Zanuccoli, Riccardo Nicoletti, Luca Trimigno, Matteo Corbellino, Sònia Travé-Huarte, Giuseppe Giannaccare, Paolo Gargiulo","doi":"10.3390/diagnostics15101199","DOIUrl":"10.3390/diagnostics15101199","url":null,"abstract":"<p><p><b>Objective</b>: This study introduces a novel method for the automated detection and quantification of meibomian gland morphology using gray value distribution profiles. The approach addresses limitations in traditional manual and deep learning-based meibography analysis, which are often time-consuming and prone to variability. <b>Methods</b>: This study enrolled 100 volunteers (mean age 40 ± 16 years, range 18-85) who suffered from dry eye and responded to the Ocular Surface Disease Index questionnaire for scoring ocular discomfort symptoms and infrared meibography for capturing imaging of meibomian glands. By leveraging pixel brightness variations, the algorithm provides real-time detection and classification of long, medium, and short meibomian glands, offering a quantitative assessment of gland atrophy. <b>Results</b>: A novel parameter, namely \"atrophy index\", a quantitative measure of gland degeneration, is introduced. Atrophy index is the first instrumental measurement to assess single- and multiple-gland morphology. <b>Conclusions</b>: This tool provides a robust, scalable metric for integrating quantitative meibography into clinical practice, making it suitable for real-time screening and advancing the management of dry eyes owing to meibomian gland dysfunction.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157212","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":"Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in Hospital-at-Home Model: Part II-Confounders and Mimickers.","authors":"Nin-Chieh Hsu, Yu-Feng Lin, Hung-Bin Tsai, Charles Liao, Chia-Hao Hsu","doi":"10.3390/diagnostics15101200","DOIUrl":"10.3390/diagnostics15101200","url":null,"abstract":"<p><p>The hospital-at-home (HaH) model offers hospital-level care within patients' homes and has proven effective for managing conditions such as pneumonia. The point-of-care ultrasonography (PoCUS) is a key diagnostic tool in this model, especially when traditional imaging modalities are unavailable. This review explores how PoCUS can be optimized to manage pneumonia in HaH settings, focusing on its diagnostic accuracy in patients with comorbidities, differentiation from mimickers, and role in assessing disease severity. Pulmonary comorbidities, such as heart failure and interstitial lung disease (ILD), can complicate lung ultrasound (LUS) interpretation. In heart failure, combining lung, cardiac, and venous assessments (e.g., IVC collapsibility, VExUS score) improves diagnostic clarity. In ILD, distinguishing chronic changes from acute infections requires attention to B-line patterns and pleural abnormalities. PoCUS must differentiate pneumonia from conditions such as atelectasis, lung contusion, cryptogenic organizing pneumonia, eosinophilic pneumonia, and neoplastic lesions-many of which present with similar sonographic features. Serial LUS scoring provides useful information on pneumonia severity and disease progression. Studies, particularly during the COVID-19 pandemic, show correlations between worsening LUS scores and poor outcomes, including increased ventilator dependency and mortality. Furthermore, LUS scores correlate with inflammatory markers and gas exchange metrics, supporting their prognostic value. In conclusion, PoCUS in HaH care requires clinicians to integrate multi-organ ultrasound findings, clinical context, and serial monitoring to enhance diagnostic accuracy and patient outcomes. Mastery of LUS interpretation in complex scenarios is crucial to delivering personalized, high-quality care in the home setting.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157320","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}