Diagnostics最新文献

{"title":"Occult Neoplasms in Sudden Unexpected Death in Infancy: A Scoping Review of Post-Mortem Findings.","authors":"Jessika Camatti, Maria Paola Bonasoni, Anita Nagy, Rossana Cecchi, Anna Laura Santunione, Erjon Radheshi","doi":"10.3390/diagnostics16193189","DOIUrl":"10.3390/diagnostics16193189","url":null,"abstract":"<p><p><b>Background:</b> Sudden unexpected death in infancy (SUDI) may occasionally be attributable to neoplasms that were clinically unrecognised before the terminal event and diagnosed or confirmed during post-mortem investigation. These occult neoplasms are exceptionally rare and remain poorly characterised. This scoping review identifies published reports of neoplasms not diagnosed or strongly suspected before the terminal event in infants who died suddenly and unexpectedly, and systematically collects data on pathological features, diagnostic modalities, mechanisms of death, and the extent to which the neoplasm contributed to death. <b>Methods:</b> A search of PubMed/MEDLINE and Scopus was conducted without a lower publication-date restriction through 19 July 2026, in accordance with Joanna Briggs Institute guidance and PRISMA-ScR. Publications describing sudden unexpected deaths in infants younger than 12 months with a previously undiagnosed neoplasm were selected and reviewed. Findings were extracted, and deaths were classified according to whether the neoplasm was causal, contributory, or incidental to death. <b>Results:</b> Twenty-five studies comprising 32 infant cases were included in the review. The median age at death was 2.5 months. The most frequent lesions were cardiovascular or thoracic neoplasms (16/32), followed by haematological or lymphoid neoplasms (6/32). Sixteen lesions were benign, ten were malignant, and six were intermediate, uncertain, or tumour-like. Twenty-five neoplasms were evident on macroscopic examination, whereas seven were identified only histologically. Reported mechanisms of death included arrhythmia, mechanical obstruction, respiratory failure, haemodynamic compromise, haemorrhage, leukostasis, and diffuse infiltration. Within the published cases included in this review, the review team classified the neoplasm as causal in 16 cases (16/32, 50.0%), contributory in 13 cases (13/32, 40.6%), and incidental in three cases (3/32, 9.4%). <b>Conclusions:</b> Autopsy examination is critical for identifying previously undiagnosed neoplasms, which are rare but potentially important findings in the investigation of SUDI. Among the selected published cases included in this review, the review team classified the neoplasm as causal in half of cases; this proportion should not be extrapolated to the broader SUDI population. Comprehensive autopsy assessment of SUDI cases, including thorough histological sampling and ancillary testing, is therefore essential for determining the role of a tumour in infant death.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191956","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":"Visual and Anatomical Outcomes of Vitrectomy with ERM and ILM Peeling in Idiopathic and Secondary ERM.","authors":"İsa Yuvaci, Kübra Özata Gündoğdu, Eda Gümrükçüoğlu","doi":"10.3390/diagnostics16193175","DOIUrl":"10.3390/diagnostics16193175","url":null,"abstract":"<p><p><b>Background/Objectives:</b> To evaluate the visual and anatomical outcomes of pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling and to assess the impact of etiological differences on postoperative outcomes. <b>Methods:</b> This retrospective study included 57 eyes of 51 patients who underwent PPV for ERM, including 34 eyes with idiopathic ERM and 23 eyes with secondary ERM. Patients were classified as having idiopathic or secondary ERM based on clinical history, fundus examination, and optical coherence tomography (OCT) findings. Best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal contour, intraoperative findings, and postoperative outcomes at 1, 3, 6, and 12 months were analyzed. Factors associated with final visual acuity were evaluated using correlation analyses and multivariate linear regression analysis. <b>Results:</b> The mean age of patients was 71.43 ± 6.46 years. BCVA improved significantly from 0.78 ± 0.35 logMAR preoperatively to 0.62 ± 0.44 logMAR at 12 months postoperatively (<i>p</i> = 0.004). Mean CMT decreased significantly from 411.68 ± 124.13 µm to 243.03 ± 89.25 µm at 12 months (<i>p</i> < 0.001). Improvement in foveal contour was observed in 70.2% of eyes; however, this anatomical improvement was not associated with better visual outcomes. In the multivariable analysis, preoperative BCVA was significantly associated with 12-month BCVA (<i>p</i> = 0.038), although the overall regression model did not reach statistical significance (<i>p</i> = 0.134). Although changes in BCVA and CMT did not differ significantly between idiopathic and secondary ERM groups, baseline BCVA-adjusted analysis showed significantly worse final BCVA in the secondary ERM group. <b>Conclusions:</b> ERM surgery with ILM peeling resulted in significant improvements in both visual and anatomical outcomes, supporting its effectiveness in achieving functional and anatomical improvement.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192149","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":"Chronic-Recurrent, Limb-Predominant Grover Disease in a Young Adult: A Clinicopathological Diagnostic Challenge.","authors":"Laura Maghiar, Andreea-Adriana Neamțu, Teodor-Andrei Maghiar, Mariana Ganea, Ovidiu Țică, Ruxandra Florina Bodog, Teodora Maria Bodog, Octavia Gligor, Laura Grațiela Vicaș, Mădălin Florin Ganea, Csaba Nagy, Ilarie Brihan","doi":"10.3390/diagnostics16193176","DOIUrl":"10.3390/diagnostics16193176","url":null,"abstract":"<p><p>Grover disease (GD), or transient acantholytic dermatosis, is an acquired acantholytic dermatosis that classically affects the trunk of older men, although persistent, recurrent and atypically distributed forms are increasingly recognised. We report a 29-year-old man with chronic-recurrent, intensely pruritic GD, with an estimated onset approximately six months before his first documented dermatologic assessment. The eruption predominantly involved the upper and lower limbs, with limited truncal involvement. Because of the atypical age and distribution, and because acantholysis was focal and minimal in individual specimens, the diagnosis rested on clinicopathological correlation across serial biopsies obtained during separate disease episodes, which showed spongiotic and acanthotic changes, focal parakeratosis, lichenoid and perivascular inflammation, and focal acantholysis with dyskeratosis. Direct immunofluorescence, performed during topical corticosteroid treatment, was nonspecific and did not support an autoimmune blistering disorder, although this result must be interpreted with caution. Laboratory investigations were unremarkable apart from a moderately elevated total serum immunoglobulin E (IgE) (223.2 IU/mL), a nonspecific finding that does not establish a type 2 immune phenotype in this patient. A combined regimen of acitretin, an oral antihistamine, a topical corticosteroid and barrier-directed care was temporally associated with marked improvement, the Dermatology Life Quality Index falling from 17/30 to 5/30 over three months. We briefly review the histopathological patterns, differential diagnosis and management of GD and its emerging molecular and immunological context. This case illustrates the breadth of the clinical spectrum of GD, the diagnostic pitfalls of focal acantholysis and of immunofluorescence performed under treatment, and the need to consider GD in young patients with chronic-recurrent, predominantly extra-truncal eruptions.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191752","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 Between the Naples Prognostic Score and In-Hospital Mortality in Patients with Type 2 Cardiorenal Syndrome: A Retrospective Cohort Study.","authors":"Eren Eynel, Emre Eynel, Yusuf Can","doi":"10.3390/diagnostics16193185","DOIUrl":"10.3390/diagnostics16193185","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluated the association between admission Naples Prognostic Score (NPS) and in-hospital mortality in patients with clinical features consistent with type 2 cardiorenal syndrome (CRS-2). <b>Methods:</b> This retrospective, single-center study included 101 adults hospitalized for decompensated heart failure at Sakarya University Training and Research Hospital between June 2021 and August 2024. CRS-2 classification relied on nephrologist review of historical records. Admission NPS combined albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. NPS was analyzed primarily as a continuous score using univariable and multivariable Firth penalized logistic regression with profile penalized-likelihood confidence intervals. Low (0-2) versus high (3-4) NPS comparisons were exploratory; no patient scored 0. <b>Results:</b> Overall, 26 patients (25.7%) died. Mortality was higher in the high-NPS than the low-NPS group (24/52 [46.2%] versus 2/49 [4.1%]; <i>p</i> < 0.001). After adjustment for age, New York Heart Association (NYHA) functional class, and left ventricular ejection fraction (LVEF), the odds ratio per one-point NPS increase was 3.42 (95% confidence interval [CI], 1.76-7.77; <i>p</i> < 0.001). The area under the receiver operating characteristic curve was 0.825 (percentile bootstrap 95% CI, 0.744-0.896). At the established NPS ≥ 3 category boundary, sensitivity was 92.3% (95% CI, 75.9-97.9%) and specificity was 62.7% (95% CI, 51.4-72.7%). Performance was estimated within the same cohort without optimism correction or external validation. <b>Conclusions:</b> Higher admission NPS was associated with in-hospital mortality after adjustment for age, NYHA class, and LVEF. These exploratory findings require external validation and assessment of incremental predictive value and clinical utility.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191790","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":"Evaluating Laryngeal Stability in Drug-Induced Parkinsonism Using Hilbert-Huang Transform and Chaos Dynamics: A Multi-Vowel Nonlinear Acoustic Framework for Differential Diagnosis.","authors":"Andrew An-Zhe Lee, Chun-Hung Lee","doi":"10.3390/diagnostics16193187","DOIUrl":"10.3390/diagnostics16193187","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Drug-induced parkinsonism (DIP) is a common extrapyramidal adverse effect of dopamine-receptor blocking agents, yet interpretable biomarkers of its acoustics remain limited. This study investigated whether nonlinear dynamics could provide physiologically interpretable markers of DIP and clarify how these abnormalities vary across vowels and extrapyramidal symptoms. <b>Methods</b>: Sustained phonations of five vowels (/a/, /i/, /u/, /e/, /o/) were analyzed in 82 patients with DIP and 30 healthy controls. Hilbert-Huang Transform (HHT) features were integrated along with Sample Entropy, Correlation Dimension, Largest Lyapunov Exponent, and Recurrence Quantification Analysis (RQA). Associations with Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) domains were examined. An external idiopathic Parkinson's disease (IPD) dataset and machine learning were used as secondary analyses to evaluate diagnostic utility. <b>Results</b>: HHT-derived features showed vowel dependence, whereas nonlinear measures revealed broader abnormalities in DIP. Sample Entropy and the Correlation Dimension were most prominently increased in rounded back vowels /u/ and /o/. RQA determinism was significantly reduced across all vowels, with recurrence rate and laminarity reduced across multiple vowels, indicating impaired recurrence of phonation. Within the DIP cohort, dyskinesia showed the strongest association with acoustic abnormalities, whereas broader motor domains, including Gait, Bradykinesia, Rigidity, Tremor, Dyskinesia, and Overall Severity, characterized patient-control differences. Secondary analyses with Random Forest achieved a three-class classification of 76.0% (CI 70.3-81.3%). <b>Conclusions</b>: DIP is associated with measurable disruption of nonlinear vocal dynamics, characterized by vowel-sensitive HHT and entropy features and relatively consistent reductions in RQA determinism. These interpretable acoustic patterns may provide a non-invasive means of characterizing extrapyramidal motor dysfunction.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191981","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":"Detection Strategies for HER2 and miR-21 in Breast Cancer: Current Approaches and Future Perspectives- Hybrid Systematic Review and Bibliometric Mapping.","authors":"Diana-Maria Burța, Simona Daniela Cavalu, Luminita Fritea, Tunde Horvath, Sebastian Nemeth, Ioana Aura Istoan, Florin Banica","doi":"10.3390/diagnostics16193179","DOIUrl":"10.3390/diagnostics16193179","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Breast cancer is still one of the main causes of mortality and morbidity at a global level, highlighting the need to identify robust biomarkers for early diagnosis, prognostic stratification and optimization of therapeutic decisions. Among these biomarkers, HER2 (Human Epidermal Growth Factor Receptor 2) and miR-21 represent the complementary levels of tumor biology, reflecting oncogenic signaling at the protein level and post-transcriptional regulation of gene expression. This hybrid systematic review and bibliometric mapping aims to critically analyze current methods for determining HER2 and miR-21 biomarkers, highlighting their advantages, limitations and clinical applicability, as well as future development directions in the field of precision oncology diagnostics. <b>Methods:</b> The bibliometric analyses were performed to investigate the intellectual structure, research trends, and collaboration patterns within the field of HER2 and miR-21 detection in breast cancer. A PRISMA-guided literature search was conducted in the Web of Science Core Collection (WoSCC), PubMed, and Scopus. After duplicate removal, screening, and eligibility assessment, 305 publications were included in the final review corpus. Bibliometric analyses of these 305 publications were performed using VOSviewer to investigate publication output, keyword co-occurrence, co-authorship, and institutional and country collaboration patterns. <b>Results:</b> Bibliometric analyses revealed the intellectual structure, research trends, and collaboration patterns within the field of HER2 and miR-21 detection in breast cancer. This work highlights the complementary role of HER2 and miR-21 biomarkers in breast cancer, highlighting their fundamental differences, but also their synergistic potential in clinical practice and translational research. A comparative analysis of detection methods highlights that, although conventional techniques remain the clinical standard, they are increasingly complemented by advanced technologies, such as digital PCR, optical and electrochemical biosensors. <b>Conclusions:</b> The emerging detection methods offer significant advantages in terms of sensitivity, rapidity and potential for miniaturization, but their clinical implementation is still limited by the lack of standardization and large-scale validation. A major bibliometric insight is the evident shift in publication output by country toward Asia, particularly China, India, and Iran, which currently show high publication output and extensive collaborative connectivity in the analyzed network. However, challenges remain in standardizing microRNA methods and the clinical validation of emerging technologies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191833","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":"Effects of Dialysate Calcium Concentration on Bone, Mineral Metabolism, and Vascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis.","authors":"Ibrahim Alabid, Wasim Iyad Ibrahim Alghoul, Malak Abedi, Mohamed El-Tanani, Mohamedanas Mohamedfaruk Patni, Syed Arman Rabbani, Huthaifa Raid Alabduli, Shams Haidar Abbas Al-Khafaji, Haya Hicham Aljarrah, Khaled Walid Elayyan, Sumaila Firoz, Mohammed Mahmood Ali","doi":"10.3390/diagnostics16193181","DOIUrl":"10.3390/diagnostics16193181","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The optimal dialysate calcium concentration in maintenance hemodialysis remains uncertain because reducing calcium exposure may limit calcium loading but can also stimulate parathyroid hormone secretion and impair intradialytic cardiovascular stability. We evaluated randomized evidence across bone, mineral metabolism, vascular, and acute safety outcomes. <b>Methods</b>: PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus were searched from database inception through 10 July 2026, with targeted citation and publication-status updating through 1 August 2026. Randomized parallel, crossover, factorial, and multi-period trials comparing dialysate calcium concentrations in adults receiving hemodialysis or hemodiafiltration were eligible. Acute and chronic outcomes were analyzed separately. Pooled estimates used inverse-variance random-effects models with DerSimonian-Laird estimation and modified Hartung-Knapp confidence intervals. <b>Results</b>: Twenty-four randomized parent trials were included. Lower dialysate calcium reduced end-of-dialysis ionized calcium (paired mean difference, -0.193 mmol/L; 95% CI, -0.258 to -0.128), with substantial heterogeneity. Point estimates for chronic parathyroid hormone and total alkaline phosphatase were higher and serum calcium lower, but all confidence intervals crossed the null. No clear effects were demonstrated for phosphate, calcium-phosphate product, lumbar bone mineral density, coronary artery calcification, or carotid intima-media thickness. Acute parathyroid hormone, blood pressure, calcium-balance, and QTc estimates suggested greater parathyroid stimulation, lower hemodynamic measures, less calcium gain, and longer QTc with lower calcium, but were imprecise. Adverse events were unsuitable for pooling. <b>Conclusions</b>: Lower dialysate calcium consistently lowers postdialysis ionized calcium, but its long-term skeletal and vascular effects remain uncertain. No single concentration appears universally optimal; prescription should be individualized according to mineral metabolism phenotype, cardiovascular tolerance, dialysis modality, and concomitant therapy.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191905","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":"Choroidal Circulation in Indolent, Nonprogressive, Multifocal Choroidal Lesions Evaluated by Multimodal Imaging Including Laser Speckle Flowgraphy.","authors":"Yui Yamashita, Mizuho Mitamura, Michiyuki Saito, Kiriko Hirooka-Nishiyama, Susumu Ishida","doi":"10.3390/diagnostics16193163","DOIUrl":"10.3390/diagnostics16193163","url":null,"abstract":"<p><p><b>Background:</b> Indolent, nonprogressive, multifocal choroidal lesions (INMCLs) are low-grade B-cell lymphoid infiltration with a good visual prognosis, yet their impact on choroidal circulation remains poorly understood. <b>Clinical Significance:</b> We report two cases of INMCLs evaluated via multimodal imaging, focusing on circulatory dynamics using laser speckle flowgraphy (LSFG). <b>Case Presentation:</b> Two patients (a 71-year-old female and a 54-year-old male) with histories of glaucoma presented with multiple yellow-white choroidal lesions at the posterior pole. Optical coherence tomography revealed extensive hyporeflective choroidal spaces in the outer choroid, while indocyanine green angiography (ICGA) showed corresponding hypofluorescent spots. Significantly, LSFG demonstrated regional reduction in LSFG signal, visualized as a \"cold colour\" pattern extending from the optic disc to the macula. Although both patients exhibited glaucomatous visual field changes, the extent to which INMCL contributed to the paracentral defects remains uncertain and difficult to separate from advanced glaucomatous damage. The clinical findings remained stable over several years without treatment. <b>Conclusions:</b> Our multimodal analysis leads to the tentative hypothesis that INMCLs may be associated with choroidal circulation disturbances, which could putatively stem from mechanical vascular compression due to localized lymphocyte accumulation. These cases highlight the potential utility of longitudinal LSFG in monitoring regional choroidal hemodynamics in INMCL, although its capability to differentiate INMCLs from other choroidal infiltrative diseases warrants validation in future comparative cohorts.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191762","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":"Computed Tomography-Guided Diagnosis of Massive Cystojejunal Bleeding.","authors":"Dragan Vasin, Goran Vukovic, Jelica Vukmirovic, Ksenija Mijovic, Aleksandar Pavlovic, Bojana Mladenovic, Danijela Sekulic, Aleksandra Pavic, Miona Jevtovic, Tijana Tomic","doi":"10.3390/diagnostics16193168","DOIUrl":"10.3390/diagnostics16193168","url":null,"abstract":"<p><p>Acute gastrointestinal bleeding is a serious emergency condition which, without prompt and accurate diagnosis, can lead to severe hemorrhagic shock and death. The initial diagnosis relies on a clinical assessment of the bleeding site. If symptoms such as hematemesis and melena are present, an esophagogastroduodenoscopy (EGD) is typically the first diagnostic procedure. In cases of massive rectal bleeding, a computed tomography scan with angiography (CTA) is often used to identify the source and cause of the bleeding. Multiphasic CTA is the definitive first-line diagnostic standard, enabling prompt diagnosis and crucial pre-procedural planning for endovascular management in massive cystojejunal bleeding.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191813","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":"Advanced Carcinoid Tricuspid Valve Disease Associated with Delayed Recognition and Loss of the Interventional Window in a Patient with Ileal Neuroendocrine Tumor: A Case Report.","authors":"Ionela Cotfas, Cosmin Banceu, Horațiu Suciu, Klara Brînzaniuc, Ileana Voichița Sirbu","doi":"10.3390/diagnostics16193160","DOIUrl":"10.3390/diagnostics16193160","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Carcinoid heart disease remains one of the most serious complications of carcinoid syndrome, yet cardiac involvement may still be recognized late, when valvular damage is already advanced and treatment options are limited. <b>Case Presentation:</b> We report a 70-year-old man with a well-differentiated ileal neuroendocrine tumor (NET G2, Ki-67 up to 5%), diagnosed in December 2019. Over six years, the disease progressed with liver metastases, markedly rising 24 h urinary 5-HIAA levels and clinically active carcinoid syndrome, and was treated sequentially with somatostatin analogues, everolimus and ¹⁷⁷Lu-DOTATOC. Throughout this period, oncological evaluation was frequent, whereas structured cardiac assessment was essentially absent until 2025. When the patient was referred for evaluation for transcatheter tricuspid repair, echocardiography demonstrated advanced carcinoid tricuspid valve disease with severe regurgitation, mild stenosis, marked leaflet thickening and tethering, and a coaptation gap of 17 mm-far beyond the ~7 mm threshold associated with favorable edge-to-edge repair and the >10 mm range associated with poor outcome. Because of the advanced valve remodeling and the overall clinical burden, the patient was not a candidate for transcatheter edge-to-edge repair or surgery and subsequently died. <b>Conclusions:</b> This case illustrates how carcinoid heart disease can progress beyond correctability and supports regular echocardiographic surveillance in patients with carcinoid syndrome, so that valve involvement is identified while intervention is still anatomically feasible.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191783","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}