Diagnostics最新文献

{"title":"Post Mortem Paliperidone Blood Concentrations Following Long-Acting Injectable Treatments.","authors":"Pietro Zuccarello, Giulia Carnazza, Antonino Petralia, Nunziata Barbera","doi":"10.3390/diagnostics15101290","DOIUrl":"10.3390/diagnostics15101290","url":null,"abstract":"<p><p><b>Background/Objectives:</b> I Paliperidone is an antipsychotic recently added into the market in various formulations. There are few data about safety and on therapeutic, toxic, or lethal blood concentrations. Currently, the published analytical methods are often applied to serum or plasma that are not obtained from cadaveric blood. Alternatively, aliquots of high volume of whole blood are used, but often in forensic investigations using samples at very small quantities. The aims of the present study were (a) to develop an analytical method to detect and quantify paliperidone in whole blood using only a small sample volume (10 µL) and (b) to summarize data on post-mortem blood analysis obtained from authentic autopsy cases. <b>Methods:</b> Method validation was carried out on 10 µL of whole blood, extracted by LLE and analyzed by LC-MS. Paliperidone concentrations obtained from blood analysis of 16 authentic autopsy cases were reported. <b>Results:</b> The method showed a good linearity and sensitivity, a normal distribution, the absence of anomalous values, an interday RSD% always less than 10%, and an 80-120% recovery, as required by AAFS guidelines. Femoral blood concentrations obtained from authentic autopsy cases ranged between 23.4 and 146.9 ng/mL. <b>Conclusions:</b> This method is to be used properly in all cases where it is necessary (a) to monitor the therapeutic adherence of patients, (b) to establish the psycho-physical conditions of the treated subject at the time of the death, and (c) to ascertain if the drug may have played a causal role in the obitus. This study reported the first data obtained from post-mortem investigation of subjects treated with paliperidone LAI. Cadaveric blood concentrations could be higher than ante-mortem reference values due to post-mortem redistribution.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157340","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":"Multiclassification of Colorectal Polyps from Colonoscopy Images Using AI for Early Diagnosis.","authors":"Jothiraj Selvaraj, Kishwar Sadaf, Shabnam Mohamed Aslam, Snekhalatha Umapathy","doi":"10.3390/diagnostics15101285","DOIUrl":"10.3390/diagnostics15101285","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, emphasizing the critical need for the accurate classification of precancerous polyps. This research presents an extensive analysis of the multiclassification framework leveraging various deep learning (DL) architectures for the automated classification of colorectal polyps from colonoscopy images. <b>Methods:</b> The proposed methodology integrates real-time data for training and utilizes a publicly available dataset for testing, ensuring generalizability. The real-time images were cautiously annotated and verified by a panel of experts, including post-graduate medical doctors and gastroenterology specialists. The DL models were designed to categorize the preprocessed colonoscopy images into four clinically significant classes: hyperplastic, serrated, adenoma, and normal. A suite of state-of-the-art models, including VGG16, VGG19, ResNet50, DenseNet121, EfficientNetV2, InceptionNetV3, Vision Transformer (ViT), and the custom-developed CRP-ViT, were trained and rigorously evaluated for this task. <b>Results:</b> Notably, the CRP-ViT model exhibited superior capability in capturing intricate features, achieving an impressive accuracy of 97.28% during training and 96.02% during validation with real-time images. Furthermore, the model demonstrated remarkable performance during testing on the public dataset, attaining an accuracy of 95.69%. To facilitate real-time interaction and clinical applicability, a user-friendly interface was developed using Gradio, allowing healthcare professionals to upload colonoscopy images and receive instant classification results. <b>Conclusions:</b> The CRP-ViT model effectively predicts and categorizes colonoscopy images into clinically relevant classes, aiding gastroenterologists in decision-making. This study highlights the potential of integrating AI-driven models into routine clinical practice to improve colorectal cancer screening outcomes and reduce diagnostic variability.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155932","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":"Sexual Functioning and Depressive Symptoms in Women with Postpartum Thyroiditis.","authors":"Karolina Kowalcze, Gaspare Cucinella, Giuseppe Gullo, Robert Krysiak","doi":"10.3390/diagnostics15101286","DOIUrl":"10.3390/diagnostics15101286","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The presence of autoimmune thyroiditis was found to be associated with an increased prevalence of sexual dysfunction. Women's sexual health was not investigated in postpartum disorders of the thyroid gland. The aim of this study was to assess female sexual functioning and depressive symptoms in postpartum thyroiditis. <b>Methods</b>: This study compared four groups of non-lactating women who gave birth within 12 months before the beginning of the study: women with postpartum thyroiditis and overt hypothyroidism (group A), women with postpartum thyroiditis and subclinical hypothyroidism (group B), euthyroid females with postpartum thyroiditis (group C) and healthy euthyroid females without thyroid disease (group D). All patients completed questionnaires assessing female sexual function (FSFI), and the presence and severity of depressive symptoms (BDI-II). Moreover, we assessed thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyroid-stimulating hormone (TSH), free thyroid hormones, testosterone, dehydroepiandrosterone sulfate (DHEAS), estradiol and prolactin. <b>Results</b>: The mean total FSFI score was lower in women with overt hypothyroidism (22.74 ± 4.12) than in the remaining groups of women, lower in groups B (25.71 ± 3.84) and C (29.67 ± 4.00) than in group D (32.15 ± 2.98), as well as lower in group B than in group C. Compared to healthy controls, both groups of women with postpartum thyroiditis and thyroid hypofunction had lower scores for all domains, while euthyroid patients with postpartum thyroiditis had lower scores for sexual desire, sexual arousal and lubrication. The total BDI-II score was highest in group A (15.6 ± 3.2) and lowest in group D (7.8 ± 3.2). Serum testosterone and DHEAS levels were lower while serum prolactin levels were higher in women with postpartum thyroiditis than in healthy subjects. The lowest testosterone levels (1.02 ± 0.35 nmol/L) and estradiol levels (190 ± 80 pmol/L) and the highest prolactin concentration (39.9 ± 13.9 ng/mL) were found in group A. <b>Conclusions</b>: The obtained results show that postpartum thyroiditis is complicated by multidimensional impairment of female sexual functioning, which is accompanied by mood deterioration. Severity of sexual dysfunction and depressive symptoms in this clinical entity depends on the degree of thyroid autoimmunity and hypothyroidism. It seems that assessment of sexual functioning and mood should be recommended to all women with postpartum thyroiditis.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157383","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":"Diagnostic Value of Multimodal Lymphatic Imaging Techniques in Thoracic Duct Outlet Obstruction.","authors":"Ying Fei, Yanli Lu, Zhichao Yao, Kongxiang Yin, Dayong Zhou, Zhanao Liu","doi":"10.3390/diagnostics15101288","DOIUrl":"10.3390/diagnostics15101288","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the diagnostic value of various lymphatic imaging techniques for thoracic duct (TD) outlet obstruction in patients with chylous leakage. <b>Methods:</b> A retrospective analysis was conducted on 23 patients with chylous leakage who were radiologically diagnosed with a TD outlet obstruction and underwent a TD exploration and reconstruction between January 2022 and February 2025. Non-enhanced magnetic resonance lymphangiography (MRL), ⁹⁹Tc^m-DX lymphoscintigraphy, and intranodal lymphangiography were employed to detect abnormalities in the central lymphatic vessels. The Receiver Operating Characteristic (ROC) curve was utilized to analyze the diagnostic performance of these imaging methods for TD outlet obstruction in lymphatic disorders. <b>Results:</b> Twenty-three patients (fifteen males and eight females) with chylous leakage were included in this study, with an average age of 59.78 ± 13.08 years. Non-enhanced MRL, ⁹⁹Tc^m-DX lymphoscintigraphy, and intranodal lymphangiography revealed TD outlet obstructions in 13, 17, and 18 patients, respectively. Twenty patients exhibited findings consistent with preoperative imaging during TD explorations; the intraoperative microscopic visualization demonstrated the difficulty of white chyle entering the bloodstream for these patients. The ROC curve analysis indicated that \"at least two imaging modalities were positive\" and had the highest Area Under the Curve (AUC) value (0.90); \"intranodal lymphangiography\" and \"non-enhanced magnetic resonance lymphangiography\" followed closely with respective AUC values of 0.76 and 0.73, and ⁹⁹Tc^m-DX lymphoscintigraphy exhibited a lower AUC value 0.63. <b>Conclusions:</b> The combined utilization of multimodal lymphatic imaging techniques demonstrated a high diagnostic accuracy in identifying TD outlet obstruction in patients with chylous leakage.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155849","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":"Immune Cells as Mediators of Lipidome Influence on Osteoporosis: Evidence from a Mediation Analysis.","authors":"Jiheng Xiao, Wei Zhou, Jiatai He, Yanbin Zhu, Yingze Zhang, Liming Xiong","doi":"10.3390/diagnostics15101287","DOIUrl":"10.3390/diagnostics15101287","url":null,"abstract":"<p><p><b>Background</b>: Although clinical studies have indicated a possible association between dyslipidemia and osteoporosis, the underlying genetic basis and mechanistic pathways remain insufficiently defined. Most prior research has concentrated on conventional lipid markers, which are prone to confounding and limit causal inference. Exploring lipidomic profiles offers a more comprehensive view of lipid metabolism and may reveal novel genetic links beyond traditional lipid traits. Additionally, alterations in immune cell function, often triggered by metabolic disturbances, may contribute to osteoporosis development; however, the potential mediating role of immune cells in the lipid-bone axis has not been systematically investigated. <b>Methods</b>: A total of 179 lipid species across 13 lipid classes were analyzed in 7174 Finnish individuals from the GeneRISK cohort. Genome-Wide Association Study (GWAS) summary statistics for osteoporosis and 731 immune cell immunophenotypes were sourced from the GWAS Catalog. A two-step, two-sample Mendelian randomization analysis, using inverse variance weighting (IVW), was conducted to explore the potential causal effects of lipids on osteoporosis and the mediating role of immune cells in the relationship between lipids and osteoporosis. <b>Results</b>: Mendelian randomization analysis indicated that triacylglycerol levels of 48:0 were possibly associated with an increased risk of osteoporosis (IVW: odds ratio [OR] 1.1320, 95% CI 1.0401-1.2321; <i>p</i> = 0.004), while triacylglycerol levels of 48:3 appeared to be associated with a reduced risk of osteoporosis (IVW: OR 0.9053, 95% CI 0.8364-0.9800; <i>p</i> = 0.014). Two statistically significant mediating effects were identified: First, IgD- CD38dim %B cells appeared to partially negatively mediate the association between triacylglycerol levels of 48:3 and osteoporosis, with a negative mediating effect of -0.00669 (95% CI: -0.0214, 0.00805), which accounted for 6.73% of the total effect. That is, the protective effect of triacylglycerol levels of 48:3 against osteoporosis was attenuated by IgD- CD38dim %B cells. Second, HLA DR++ monocytes% leukocytes also partially negatively mediated this relationship, with a mediating effect of -0.023 (95% CI: -0.0434, -0.00266), accounting for 23.2% of the total effect. This indicates that other immune cells, HLA DR++ monocytes %leukocytes, resisted the protective effect of triacylglycerol levels of 48:3 against osteoporosis, with a weakening effect stronger than that of IgD- CD38dim %B cells. <b>Conclusions</b>: Our findings contribute to the growing understanding of the potential causal relationships and shared pathogenic mechanisms between dyslipidemia and osteoporosis. The results suggest that the potential genetic effects of plasma lipid metabolites on osteoporosis may be partially down-regulated by specific kinds of immune cells.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157310","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 Clinical and Laboratory Profiles of a Deletional α2-Globin Gene Polyadenylation Signal Sequence (AATAAA > AATA--) [HBA2:c.*93_*94delAA]: The Malaysian Experience.","authors":"Norafiza Mohd Yasin, Syahzuwan Hassan, Nur Aisyah Aziz, Faidatul Syazlin Abdul Hamid, Ezalia Esa, Ezzanie Suffya Zulkefli, Rohana Ghazali, Syirah Nazirah Tajuddin, Mohd Nazif Darawi, Yuslina Mat Yusoff, Cornelis L Harteveld","doi":"10.3390/diagnostics15101284","DOIUrl":"10.3390/diagnostics15101284","url":null,"abstract":"<p><p>Poly A (AATAAA > AATA--) [HBA2:c.*93_*94delAA] is a rare α-variant reported in our population. It is caused by 2 bp deletion (--AA) in the α2 poly A sequence, leading to a significant α-thalassaemia phenotype. <b>Background/Objectives</b>: This study describes the haematological parameters, phenotype, and genotype characteristics of AATA(--AA) in the Malaysian population. <b>Methods</b>: The study was carried out on 17 177 cases referred to the Institute for Medical Research, Malaysia, for further diagnosis of α-thalassaemia in a five-year period. Alpha-Gap and ARMS-PCR were performed to detect common α-thalassaemia, followed by <i>HBA1</i> and <i>HBA2</i> genes sequencing and multiplex ligation-dependent probe amplification (MLPA). Haematological parameters among various groups with the AATA(--AA) allele were presented in this study. <b>Results</b>: Thirty-two patients with AATA(--AA) displaying an α-thalassaemia-like phenotype were analysed. They comprised 22 (68.75%) AATA(--AA) carriers, 2 (6.25%) compounds with 3.7 deletion, 2 (6.25%) compounds with --SEA deletion, 1 (3.12%) AATA(--AA) homozygote, and 3 (9.37%) compounds of Hb Adana, Hb CS, and Hb Pakse with co-inheritance Hb E, respectively. Most of the patients with AATA(--AA) compounds with the α-variant exhibited a significant phenotype between moderate to severe thalassaemia, especially cases with compound α^-AAα/α^Adanaα. <b>Conclusions</b>: AATA(--AA) is a significant pathogenic variant that should be diagnosed to prevent significant thalassaemia phenotype or transfusion-dependent thalassaemia.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155934","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 the Role of Peritumoral Edema in Predicting Lung Cancer Subtypes Through T2-FLAIR Digital Subtraction Imaging of Metastatic Brain Tumors.","authors":"Okan Dilek, Emin Demırel, Zeynel Abidin Tas, Emre Bılgın","doi":"10.3390/diagnostics15101283","DOIUrl":"10.3390/diagnostics15101283","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to investigate whether small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) can be distinguished based on radiomics data derived from T2-FLAIR digital subtraction images of the peritumoral edema region in patients with brain metastases. <b>Methods:</b> A total of 136 patients who underwent surgery for brain tumors, including 100 patients in the Pretreat-Metstobrain-MASKS dataset and 36 patients from our institution, were included in our study. Radiomic features were extracted from digitally subtracted T2-FLAIR images in the peritumoral edema area. Patients were divided into NSCLC and SCLC groups. The maximum relevance-minimum redundancy (mRMR) method was then used for dimensionality reduction. The Naive Bayes algorithm was used for model development, and the interpretability of the model was explored using SHapley Additive exPlanations (SHAP). The performance metrics included the area under the curve (AUC), sensitivity (SENS), and specificity (SPEC). <b>Results:</b> The mean age of NSCLC patients was 64.6 ± 10.3 years, and that of SCLC patients was 63.4 ± 11.7 years. In the external validation cohort, the model achieved an AUC of 0.82 (0.68-0.97), a SENS of 0.87 (0.74-0.91), and a SPEC of 0.72 (0.72-0.89). In the train cohort, the model achieved an AUC of 1.000, a SENS of 1.000, and a SPEC of 1.000. The feature providing the best effect was wavelet-HHHglcmJointEnergy, with a SHAP value of approximately 2.5. <b>Conclusions:</b> An artificial intelligence model developed using radiomics data from T2-FLAIR digital subtraction images of the peritumoral edema area can identify the histologic type of lung cancer in patients with associated brain metastases.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157302","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":"Association of [¹⁸F]-FDG PET/CT-Derived Radiomic Features with Clinical Outcomes and Genomic Profiles in Patients with Chronic Lymphocytic Leukemia.","authors":"Fabiana Esposito, Luigi Manco, Guglielmo Manenti, Livio Pupo, Andrea Nunzi, Roberta Laureana, Luca Guarnera, Massimiliano Marinoni, Elisa Buzzatti, Paola Elda Gigliotti, Andrea Micillo, Giovanni Scribano, Adriano Venditti, Massimiliano Postorino, Maria Ilaria Del Principe","doi":"10.3390/diagnostics15101281","DOIUrl":"10.3390/diagnostics15101281","url":null,"abstract":"<p><p><b>Background:</b> The role of PET/CT imaging in chronic lymphoproliferative syndromes (CLL) is debated. This study examines the potential of PET/CT radiomics in predicting outcomes and genetic profiles in CLL patients. <b>Methods:</b> A retrospective analysis was conducted on 50 CLL patients treated at Policlinico Tor Vergata, Rome, and screened, at diagnosis, with [¹⁸F]-FDG PET/CT. Potentially pathological lymph nodes were semi-automatically segmented. Genetic mutations in <i>TP53</i>, <i>NOTCH1</i>, and <i>IGVH</i> were assessed. Eight hundred and sixty-five radiomic features were extracted, with the cohort split into training (70%) and validation (30%) sets. Four machine learning models, each with Random Forest, Stochastic Gradient Descent, and Support Vector Machine learners, were trained. <b>Results:</b> Progression occurred in 10 patients. The selected radiomic features from CT and PET datasets were correlated with four models of progression and mutations (<i>TP53</i>, <i>NOTCH1</i>, <i>IGVH</i>). The Random Forest models outperformed others in predicting progression (AUC = 0.94/0.88, CA = 0.87/0.75, TP = 80.00%/87.50%, TN = 72.70%/87.50%) and the occurrence of <i>TP53</i> (AUC = 0.94/0.96, CA = 0.87/0.80, TP = 87.50%/90.21%, TN = 85.70%/90.90%), and <i>NOTCH1</i> (AUC = 0.94/0.85, CA = 0.87/0.67, TP = 80.00%/88.90%, TN = 80.00%/83.30%)mutations. The IGVH models showed poorer performance. <b>Conclusions:</b> ML models based on PET/CT radiomic features effectively predict outcomes and genetic profiles in CLL patients.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157218","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":"Efficacy of Hyperosmolar Dextrose Injection for Osgood-Schlatter Disease: A Systematic Review with Meta-Analysis.","authors":"Hye Chang Rhim, Lori B Bjork, Jaehyung Shin, Jewel Park, Stephanie E DeLuca, Katelyn C McCarron, Ki-Mo Jang, Chris Ha","doi":"10.3390/diagnostics15101282","DOIUrl":"10.3390/diagnostics15101282","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Although Osgood-Schlatter disease (OSD) is often self-limiting following apophyseal closure, it may cause persistent symptoms into adulthood, affecting physical and functional activities. The purpose of this systematic review is to summarize the current evidence on the efficacy of hyperosmolar dextrose injection for patients with OSD unresponsive to conservative treatment. <b>Methods:</b> Multiple databases were searched for studies investigating the efficacy of hyperosmolar dextrose injection in patients with OSD. Two reviewers independently extracted data and evaluated the risk of bias. Meta-analyses were performed to compare hyperosmolar dextrose injection with placebo injections. <b>Results:</b> Four studies including three randomized controlled trials (RCTs) and one case series involving a total of 166 (162 males and 4 females) patients with 184 knees were included in this review. At three months, there was no significant difference in patient-reported improvement from baseline between hyperosmolar dextrose injection and placebo injections (standardized mean difference [SMD] = 1.92, 95% confidence interval [CI], -0.12 to 3.96; I² = 96.2%). However, a meta-analysis of two RCTs including athletic pediatric patients found a pooled risk ratio of 2.11 (95% CI: 1.12 to 3.98, I² = 30.73%) for pain-free return to sports at three months. In addition, at one year, a meta-analysis of two RCTs showed greater patient-reported improvement from baseline with hyperosmolar dextrose injection compared to placebo (SMD = 1.09, 95% CI, 0.62 to 1.56; I²= 0%). <b>Conclusions:</b> Based on the limited number of RCTs, although no improvement in patient-reported outcomes is seen at three months, hyperosmolar dextrose injection may safely facilitate a pain-free return to sports at three months and lead to patient-reported improvement at one year. However, further high-quality RCTs are needed to substantiate these findings.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12110050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157297","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":"Tumor Cavitation with Anlotinib Treatment in Lung Adenocarcinoma.","authors":"Jie Huang, Xueqin Chen","doi":"10.3390/diagnostics15101280","DOIUrl":"10.3390/diagnostics15101280","url":null,"abstract":"<p><p>Tumor cavitation is distinguished by the emergence of central necrosis and cavity formation within the tumor mass, which indicates a notable outcome of anti-angiogenic therapies. This case describes a 52-year-old Chinese female with advanced EGFR-mutated lung adenocarcinoma (Exon 19 deletion), which was metastatic to bilateral lungs, brain, and right adrenal gland, who exhibited a radiographic response to combination therapy with the third-generation EGFR tyrosine kinase inhibitor (TKI) aumolertinib and the anti-angiogenic agent anlotinib. The patient achieved near-complete cavitation of almost all bilateral lung nodules, manifesting as distinctive \"bullet hole\" lesions on the chest CT. Despite this initial response, disease progression occurred two months later with new liver metastases, culminating in the patient's death. This case underscores the potential efficacy of EGFR TKIs and anti-angiogenic agents in inducing unique tumor microenvironment modifications, while highlighting the transient nature of such responses and the critical need to address resistance mechanisms. Tumor cavitation may serve as a radiographic marker of anti-angiogenic activity but does not preclude metastatic spread, necessitating vigilant monitoring even in the setting of favorable imaging changes.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157324","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}