Pub Date : 2026-02-03DOI: 10.3390/diagnostics16030470
Alicia Rodriguez-Pla
Giant cell arteritis (GCA) represents one of the most diagnostically challenging systemic vasculitides, characterized by its heterogeneous clinical presentation, lack of pathognomonic features, and potential for devastating complications, with a special concern for irreversible vision loss. This comprehensive review synthesizes current evidence regarding the multifaceted diagnostic challenges in GCA, incorporating recent advances in classification criteria, imaging technologies, biomarker research, and emerging therapeutic strategies.
{"title":"Diagnostic Challenges and Modern Therapeutic Strategies in Giant Cell Arteritis.","authors":"Alicia Rodriguez-Pla","doi":"10.3390/diagnostics16030470","DOIUrl":"https://doi.org/10.3390/diagnostics16030470","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) represents one of the most diagnostically challenging systemic vasculitides, characterized by its heterogeneous clinical presentation, lack of pathognomonic features, and potential for devastating complications, with a special concern for irreversible vision loss. This comprehensive review synthesizes current evidence regarding the multifaceted diagnostic challenges in GCA, incorporating recent advances in classification criteria, imaging technologies, biomarker research, and emerging therapeutic strategies.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objectives: Early detection and intervention are critical for improving outcomes in head and neck cancer. Although endoscopy is commonly used for screening, it requires specialist expertise and may cause patient discomfort. Therefore, there is a need for a simpler and less invasive screening method. This study aimed to evaluate the clinical feasibility of Fourier-transform infrared (FTIR) spectroscopy-based exhaled breath analysis as a non-invasive screening tool for head and neck cancer. Methods: This single-center study was conducted at the Department of Otolaryngology-Head and Neck Surgery, Showa Medical University. Outpatients with head and neck cancer (n = 10) and healthy controls (n = 14) were enrolled. Exhaled breath samples and ambient air surrounding the patient and lesion were analyzed using FTIR spectroscopy. Infrared absorption spectra were obtained, divided into 7667 discrete wavenumber points across the measured range, and compared between the patient and control groups. Results: FTIR spectroscopy revealed significant differences between patients and controls, with 2691 wavenumber points showing statistically significant differences (p < 0.05). Among these, the wavenumber at 3917.3 cm-1 showed a particularly strong difference (p = 0.00015). Receiver operating characteristic analysis demonstrated good discriminative performance, with an area under the curve of 0.929. The maximum Youden index was 0.829, with an optimal threshold of 0.234. Conclusions: FTIR-based exhaled breath analysis is a non-invasive and feasible approach for screening head and neck cancer. These findings suggest that this technique has potential clinical applicability as a screening tool and may also be extendable to the detection of other diseases.
{"title":"Exhaled Breath Analysis for Head and Neck Cancer Using Fourier-Transform Infrared Spectroscopy: A Feasibility Study for Non-Invasive Screening.","authors":"Kota Nakasuji, Yoshihito Tanaka, Masato Yamamoto, Hidehiko Honda, Hirokazu Kobayashi, Toshikazu Shimane, Hitome Kobayashi, Masakazu Murayama, Takahiro Ishima","doi":"10.3390/diagnostics16030477","DOIUrl":"https://doi.org/10.3390/diagnostics16030477","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Early detection and intervention are critical for improving outcomes in head and neck cancer. Although endoscopy is commonly used for screening, it requires specialist expertise and may cause patient discomfort. Therefore, there is a need for a simpler and less invasive screening method. This study aimed to evaluate the clinical feasibility of Fourier-transform infrared (FTIR) spectroscopy-based exhaled breath analysis as a non-invasive screening tool for head and neck cancer. <b>Methods:</b> This single-center study was conducted at the Department of Otolaryngology-Head and Neck Surgery, Showa Medical University. Outpatients with head and neck cancer (<i>n</i> = 10) and healthy controls (<i>n</i> = 14) were enrolled. Exhaled breath samples and ambient air surrounding the patient and lesion were analyzed using FTIR spectroscopy. Infrared absorption spectra were obtained, divided into 7667 discrete wavenumber points across the measured range, and compared between the patient and control groups. <b>Results:</b> FTIR spectroscopy revealed significant differences between patients and controls, with 2691 wavenumber points showing statistically significant differences (<i>p</i> < 0.05). Among these, the wavenumber at 3917.3 cm<sup>-1</sup> showed a particularly strong difference (<i>p</i> = 0.00015). Receiver operating characteristic analysis demonstrated good discriminative performance, with an area under the curve of 0.929. The maximum Youden index was 0.829, with an optimal threshold of 0.234. <b>Conclusions:</b> FTIR-based exhaled breath analysis is a non-invasive and feasible approach for screening head and neck cancer. These findings suggest that this technique has potential clinical applicability as a screening tool and may also be extendable to the detection of other diseases.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.3390/diagnostics16030476
Sadık Emre Erginoğlu, Nuri Koray Ülgen, Nihat Yiğit, Ali Said Nazlıgül, Mehmet Orçun Akkurt
<p><p><b>Background</b>: Rapid and accurate fracture detection is critical in emergency departments (EDs), where high patient volume and time pressure increase the risk of diagnostic error, particularly in radiographic interpretation. Multimodal large language models (LLMs) with image-recognition capability have recently emerged as general-purpose tools for clinical decision support, but their diagnostic performance within routine emergency department imaging workflows in orthopedic trauma remains unclear. <b>Methods</b>: In this retrospective diagnostic accuracy study, we included 1136 consecutive patients referred from the ED to orthopedics between 1 January and 1 June 2025 at a single tertiary center. Given the single-center, retrospective design, the findings should be interpreted as hypothesis-generating and may not be fully generalizable to other institutions. Emergency radiographs and clinical data were processed by a multimodal LLM (2025 version) via an official API using a standardized, deterministic prompt. The model's outputs ("Fracture present", "No fracture", or "Uncertain") were compared with final diagnoses established by blinded orthopedic specialists, which served as the reference standard. Diagnostic agreement was analyzed using Cohen's kappa (κ), sensitivity, specificity, accuracy, and 95% confidence intervals (CIs). False-negative (FN) cases were defined as instances where the LLM reported "no acute fracture" but the specialist identified a fracture. The evaluated system is a general-purpose multimodal LLM and was not trained specifically on orthopedic radiographs. <b>Results</b>: Overall, the LLM showed good diagnostic agreement with orthopedic specialists, with concordant results in 808 of 1136 patients (71.1%; κ = 0.634; 95% CI: 68.4-73.7). The model achieved balanced performance with sensitivity of 76.9% and specificity of 66.8%. The highest agreement was observed in knee trauma (91.7%), followed by wrist (78.8%) and hand (69.6%). False-negative cases accounted for 184 patients (16.2% of the total cohort), representing 32.4% of all LLM-negative assessments. Most FN fractures were non-displaced (82.6%), and 17.4% of FN cases required surgical treatment. Ankle and foot regions showed the highest FN rates (30.4% and 17.4%, respectively), reflecting the anatomical and radiographic complexity of these areas. Positive predictive value (PPV) and negative predictive value (NPV) were 69.4% and 74.5%, respectively, with likelihood ratios indicating moderate shifts in post-test probability. <b>Conclusions</b>: In an emergency department-to-orthopedics consultation cohort reflecting routine clinical workflow, a multimodal LLM demonstrated moderate-to-good diagnostic agreement with orthopedic specialists, broadly within the range reported in prior fracture-detection AI studies; however, these comparisons are indirect because model architectures, training strategies, datasets, and endpoints differ across studies. However, its limited ab
{"title":"Multimodal Large Language Model for Fracture Detection in Emergency Orthopedic Trauma: A Diagnostic Accuracy Study.","authors":"Sadık Emre Erginoğlu, Nuri Koray Ülgen, Nihat Yiğit, Ali Said Nazlıgül, Mehmet Orçun Akkurt","doi":"10.3390/diagnostics16030476","DOIUrl":"https://doi.org/10.3390/diagnostics16030476","url":null,"abstract":"<p><p><b>Background</b>: Rapid and accurate fracture detection is critical in emergency departments (EDs), where high patient volume and time pressure increase the risk of diagnostic error, particularly in radiographic interpretation. Multimodal large language models (LLMs) with image-recognition capability have recently emerged as general-purpose tools for clinical decision support, but their diagnostic performance within routine emergency department imaging workflows in orthopedic trauma remains unclear. <b>Methods</b>: In this retrospective diagnostic accuracy study, we included 1136 consecutive patients referred from the ED to orthopedics between 1 January and 1 June 2025 at a single tertiary center. Given the single-center, retrospective design, the findings should be interpreted as hypothesis-generating and may not be fully generalizable to other institutions. Emergency radiographs and clinical data were processed by a multimodal LLM (2025 version) via an official API using a standardized, deterministic prompt. The model's outputs (\"Fracture present\", \"No fracture\", or \"Uncertain\") were compared with final diagnoses established by blinded orthopedic specialists, which served as the reference standard. Diagnostic agreement was analyzed using Cohen's kappa (κ), sensitivity, specificity, accuracy, and 95% confidence intervals (CIs). False-negative (FN) cases were defined as instances where the LLM reported \"no acute fracture\" but the specialist identified a fracture. The evaluated system is a general-purpose multimodal LLM and was not trained specifically on orthopedic radiographs. <b>Results</b>: Overall, the LLM showed good diagnostic agreement with orthopedic specialists, with concordant results in 808 of 1136 patients (71.1%; κ = 0.634; 95% CI: 68.4-73.7). The model achieved balanced performance with sensitivity of 76.9% and specificity of 66.8%. The highest agreement was observed in knee trauma (91.7%), followed by wrist (78.8%) and hand (69.6%). False-negative cases accounted for 184 patients (16.2% of the total cohort), representing 32.4% of all LLM-negative assessments. Most FN fractures were non-displaced (82.6%), and 17.4% of FN cases required surgical treatment. Ankle and foot regions showed the highest FN rates (30.4% and 17.4%, respectively), reflecting the anatomical and radiographic complexity of these areas. Positive predictive value (PPV) and negative predictive value (NPV) were 69.4% and 74.5%, respectively, with likelihood ratios indicating moderate shifts in post-test probability. <b>Conclusions</b>: In an emergency department-to-orthopedics consultation cohort reflecting routine clinical workflow, a multimodal LLM demonstrated moderate-to-good diagnostic agreement with orthopedic specialists, broadly within the range reported in prior fracture-detection AI studies; however, these comparisons are indirect because model architectures, training strategies, datasets, and endpoints differ across studies. However, its limited ab","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.3390/diagnostics16030468
Faisal Binzagr, Majed Hariri
Background: The precise segmentation and classification of dermoscopic images remain prominent obstacles in automated skin cancer evaluation due, in part, to variability in lesions, low-contrast borders, and additional artifacts in the background. There have been recent developments in foundation models, with a particular emphasis on the Segment Anything Model (SAM)-these models exhibit strong generalization potential but require domain-specific adaptation to function effectively in medical imaging. The advent of new architectures, particularly Vision Transformers (ViTs), expands the means of implementing robust lesion identification; however, their strengths are limited without spatial priors. Methods: The proposed study lays out an integrated foundation-model-based framework that utilizes SAM-Adapter-fine-tuning for lesion segmentation and a ViT-based classifier that incorporates lesion-specific cropping derived from segmentation and cross-attention fusion. The SAM encoder is kept frozen while lightweight adapters are fine-tuned only, to introduce skin surface-specific capacity. Segmentation priors are incorporated during the classification stage through fusion with patch-embeddings from the images, creating lesion-centric reasoning. The entire pipeline is trained using a joint multi-task approach using data from the ISIC 2018, HAM10000, and PH2 datasets. Results: From extensive experimentation, the proposed method outperforms the state-of-the-art segmentation and classification across the dataset. On the ISIC 2018 dataset, it achieves a Dice score of 94.27% for segmentation and an accuracy of 95.88% for classification performance. On PH2, a Dice score of 95.62% is achieved, and for HAM10000, an accuracy of 96.37% is achieved. Several ablation analyses confirm that both the SAM-Adapters and lesion-specific cropping and cross-attention fusion contribute substantially to performance. Paired t-tests are used to confirm statistical significance for all the previously stated measures where improvements over strong baselines indicate a p<0.01 for most comparisons and with large effect sizes. Conclusions: The results indicate that the combination of prior segmentation from foundation models, plus transformer-based classification, consistently and reliably improves the quality of lesion boundaries and diagnosis accuracy. Thus, the proposed SAM-ViT framework demonstrates a robust, generalizable, and lesion-centric automated dermoscopic analysis, and represents a promising initial step towards clinically deployable skin cancer decision-support system. Next steps will include model compression, improved pseudo-mask refinement and evaluation on real-world multi-center clinical cohorts.
{"title":"Foundation-Model-Driven Skin Lesion Segmentation and Classification Using SAM-Adapters and Vision Transformers.","authors":"Faisal Binzagr, Majed Hariri","doi":"10.3390/diagnostics16030468","DOIUrl":"https://doi.org/10.3390/diagnostics16030468","url":null,"abstract":"<p><p><b>Background:</b> The precise segmentation and classification of dermoscopic images remain prominent obstacles in automated skin cancer evaluation due, in part, to variability in lesions, low-contrast borders, and additional artifacts in the background. There have been recent developments in foundation models, with a particular emphasis on the Segment Anything Model (SAM)-these models exhibit strong generalization potential but require domain-specific adaptation to function effectively in medical imaging. The advent of new architectures, particularly Vision Transformers (ViTs), expands the means of implementing robust lesion identification; however, their strengths are limited without spatial priors. <b>Methods:</b> The proposed study lays out an integrated foundation-model-based framework that utilizes SAM-Adapter-fine-tuning for lesion segmentation and a ViT-based classifier that incorporates lesion-specific cropping derived from segmentation and cross-attention fusion. The SAM encoder is kept frozen while lightweight adapters are fine-tuned only, to introduce skin surface-specific capacity. Segmentation priors are incorporated during the classification stage through fusion with patch-embeddings from the images, creating lesion-centric reasoning. The entire pipeline is trained using a joint multi-task approach using data from the ISIC 2018, HAM10000, and PH2 datasets. <b>Results:</b> From extensive experimentation, the proposed method outperforms the state-of-the-art segmentation and classification across the dataset. On the ISIC 2018 dataset, it achieves a Dice score of 94.27% for segmentation and an accuracy of 95.88% for classification performance. On PH2, a Dice score of 95.62% is achieved, and for HAM10000, an accuracy of 96.37% is achieved. Several ablation analyses confirm that both the SAM-Adapters and lesion-specific cropping and cross-attention fusion contribute substantially to performance. Paired <i>t</i>-tests are used to confirm statistical significance for all the previously stated measures where improvements over strong baselines indicate a p<0.01 for most comparisons and with large effect sizes. <b>Conclusions:</b> The results indicate that the combination of prior segmentation from foundation models, plus transformer-based classification, consistently and reliably improves the quality of lesion boundaries and diagnosis accuracy. Thus, the proposed SAM-ViT framework demonstrates a robust, generalizable, and lesion-centric automated dermoscopic analysis, and represents a promising initial step towards clinically deployable skin cancer decision-support system. Next steps will include model compression, improved pseudo-mask refinement and evaluation on real-world multi-center clinical cohorts.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.3390/diagnostics16030469
Giovanni Iudicelli, Francesco Agostini, Alberto Altarocca, Francesco Ioppolo, Marco Narciso, Marco Conti, Andrea Fisicaro, Alessio Savina, Vincenzo Di Nunno, Massimiliano Mangone, Stefano Galletti, Marco Paoloni
Background: Superior cluneal nerve (SCN) entrapment is frequently underrecognized as a contributor to chronic Low Back Pain (cLBP) and gluteal pain. Musculoskeletal ultrasound may reveal surrogate markers indicative of a biomechanical entrapment environment. The primary objective was the prevalence of the ultrasound marker triad (Copeman Nod-ules-CN, thoracolumbar fascia-TLF thickening > 3 mm, and iliac enthesophytes. Secondary objectives included mean TLF thickness and its correlation with numeric pain rating scale (NPRS) and Douleur Neuropathique en 4 questions scores (DN4). Methods: In this single-center, cross-sectional observational pilot study, we enrolled 12 patients with cLBP (>12 weeks) localized to the SCN distribution and a healthy control group (12). Ultrasound measurements included TLF thickness in longitudinal and transverse planes, TLF convexity loss, iliac crest enthesophytes, and CN. Statistical analyses comprised Mann-Whitney U test, Fisher exact test, Spearman rank correlation, and multivariate logistic regression. Significance was set at p < 0.05. Results: The ultrasound marker triad (CN, iliac enthesophytes, and TLF thickening > 3 mm) demonstrated high diagnostic specificity: individually, CN were present in 91.7% of patients vs. 8.3% of controls (p < 0.001), iliac enthesophytes in 58.3% vs. 0% (p = 0.005), TLF thickening > 3 mm in 41.7% of patients vs. 0% of controls (p < 0.001)and TLF convexity loss in 100% vs. 75% (p = 0.03). Mean TLF thickness was significantly greater in patients-3.53 ± 0.46 mm longitudinal and 3.42 ± 0.39 mm transverse-compared with controls (2.61 ± 0.28 mm and 2.50 ± 0.32 mm; both p < 0.001). TLF thickness correlated strongly with NPRS (Spearman rho = 0.825; p = 0.001) but not with DN4. Logistic regression demonstrated that the marker triad accounted for 67% of NPRS variance (R2 = 0.67). Conclusions: Ultrasound-detected fascial alterations and enthesopathic changes act as reliable surrogate markers for SCN entrapment and correlate strongly with nociceptive pain severity. The absence of correlation with neuropathic pain scores suggests a predominant fascial-muscular biomechanical mechanism rather than direct nerve damage. Incorporating this non-invasive protocol into clinical practice may enhance diagnostic precision and inform targeted rehabilitative strategies. Future multicenter, prospective studies with larger cohorts are warranted to validate these findings and establish standardized ultrasound criteria.
{"title":"The Role of Musculoskeletal Ultrasound in Detecting Superior Cluneal Nerve Entrapment: Biomechanical Insights in Chronic Low Back Pain-A Pilot Study.","authors":"Giovanni Iudicelli, Francesco Agostini, Alberto Altarocca, Francesco Ioppolo, Marco Narciso, Marco Conti, Andrea Fisicaro, Alessio Savina, Vincenzo Di Nunno, Massimiliano Mangone, Stefano Galletti, Marco Paoloni","doi":"10.3390/diagnostics16030469","DOIUrl":"https://doi.org/10.3390/diagnostics16030469","url":null,"abstract":"<p><p><b>Background</b>: Superior cluneal nerve (SCN) entrapment is frequently underrecognized as a contributor to chronic Low Back Pain (cLBP) and gluteal pain. Musculoskeletal ultrasound may reveal surrogate markers indicative of a biomechanical entrapment environment. The primary objective was the prevalence of the ultrasound marker triad (Copeman Nod-ules-CN, thoracolumbar fascia-TLF thickening > 3 mm, and iliac enthesophytes. Secondary objectives included mean TLF thickness and its correlation with numeric pain rating scale (NPRS) and Douleur Neuropathique en 4 questions scores (DN4). <b>Methods</b>: In this single-center, cross-sectional observational pilot study, we enrolled 12 patients with cLBP (>12 weeks) localized to the SCN distribution and a healthy control group (12). Ultrasound measurements included TLF thickness in longitudinal and transverse planes, TLF convexity loss, iliac crest enthesophytes, and CN. Statistical analyses comprised Mann-Whitney U test, Fisher exact test, Spearman rank correlation, and multivariate logistic regression. Significance was set at <i>p</i> < 0.05. <b>Results</b>: The ultrasound marker triad (CN, iliac enthesophytes, and TLF thickening > 3 mm) demonstrated high diagnostic specificity: individually, CN were present in 91.7% of patients vs. 8.3% of controls (<i>p</i> < 0.001), iliac enthesophytes in 58.3% vs. 0% (<i>p</i> = 0.005), TLF thickening > 3 mm in 41.7% of patients vs. 0% of controls (<i>p</i> < 0.001)and TLF convexity loss in 100% vs. 75% (<i>p</i> = 0.03). Mean TLF thickness was significantly greater in patients-3.53 ± 0.46 mm longitudinal and 3.42 ± 0.39 mm transverse-compared with controls (2.61 ± 0.28 mm and 2.50 ± 0.32 mm; both <i>p</i> < 0.001). TLF thickness correlated strongly with NPRS (Spearman rho = 0.825; <i>p</i> = 0.001) but not with DN4. Logistic regression demonstrated that the marker triad accounted for 67% of NPRS variance (R<sup>2</sup> = 0.67). <b>Conclusions</b>: Ultrasound-detected fascial alterations and enthesopathic changes act as reliable surrogate markers for SCN entrapment and correlate strongly with nociceptive pain severity. The absence of correlation with neuropathic pain scores suggests a predominant fascial-muscular biomechanical mechanism rather than direct nerve damage. Incorporating this non-invasive protocol into clinical practice may enhance diagnostic precision and inform targeted rehabilitative strategies. Future multicenter, prospective studies with larger cohorts are warranted to validate these findings and establish standardized ultrasound criteria.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.3390/diagnostics16030473
Qin Liu, Xingqian Shen, Linlin Wang, Yangming Leng, Cen Chen, Ping Lei, Bo Liu
Objectives: To investigate the differences in inner ear anatomical variations between patients with acute low-tone sensorineural hearing loss (ALHL) and those with unilateral stage I/II Ménière's disease (MD) based on magnetic resonance imaging (MRI). Methods: A total of 30 patients with unilateral ALHL, 41 patients with unilateral stage I/II MD, and 59 healthy controls were enrolled retrospectively. 3.0T MRI was used to evaluate the distance between the vertical part of the posterior semicircular canal and the posterior fossa (PPD) and vestibular aqueduct (VA) visibility. Inter-group and intra-group comparisons and correlation analyses were performed to clarify the characteristics of anatomical variations. Results: (1) There were no significant differences in PPD and VA visibility between ALHL patients and healthy controls; the PPD of unaffected ears in MD patients was significantly shorter than that in healthy controls, while no significant difference was observed in the PPD of affected ears between MD patients and healthy controls. (2) The VA visibility of affected ears in ALHL patients was significantly higher than that in MD patients. (3) No significant intra-group differences in PPD and VA visibility between affected and unaffected ears were noted in ALHL or MD patients. (4) A significant negative correlation was found between the PPD of affected ears and pure tone average of affected ears in MD patients, while no correlations were observed between anatomical indices and clinical characteristics in ALHL patients. Conclusions: Although both ALHL and MD are categorized as hydropic ear diseases, radiological evidences demonstrate that MD patients exhibit inner ear anatomical variations, whereas no significant anatomical variations are observed in ALHL patients. This suggests that anatomical variations in the endolymphatic drainage system may be a predisposing factor for the pathogenesis of unilateral MD rather than for unilateral ALHL.
{"title":"Inner Ear Anatomy Variations in Acute Low-Tone Sensorineural Hearing Loss and Unilateral Stage I/II Ménière's Disease: A Comparative Study.","authors":"Qin Liu, Xingqian Shen, Linlin Wang, Yangming Leng, Cen Chen, Ping Lei, Bo Liu","doi":"10.3390/diagnostics16030473","DOIUrl":"https://doi.org/10.3390/diagnostics16030473","url":null,"abstract":"<p><p><b>Objectives</b>: To investigate the differences in inner ear anatomical variations between patients with acute low-tone sensorineural hearing loss (ALHL) and those with unilateral stage I/II Ménière's disease (MD) based on magnetic resonance imaging (MRI). <b>Methods</b>: A total of 30 patients with unilateral ALHL, 41 patients with unilateral stage I/II MD, and 59 healthy controls were enrolled retrospectively. 3.0T MRI was used to evaluate the distance between the vertical part of the posterior semicircular canal and the posterior fossa (PPD) and vestibular aqueduct (VA) visibility. Inter-group and intra-group comparisons and correlation analyses were performed to clarify the characteristics of anatomical variations. <b>Results</b>: (1) There were no significant differences in PPD and VA visibility between ALHL patients and healthy controls; the PPD of unaffected ears in MD patients was significantly shorter than that in healthy controls, while no significant difference was observed in the PPD of affected ears between MD patients and healthy controls. (2) The VA visibility of affected ears in ALHL patients was significantly higher than that in MD patients. (3) No significant intra-group differences in PPD and VA visibility between affected and unaffected ears were noted in ALHL or MD patients. (4) A significant negative correlation was found between the PPD of affected ears and pure tone average of affected ears in MD patients, while no correlations were observed between anatomical indices and clinical characteristics in ALHL patients. <b>Conclusions</b>: Although both ALHL and MD are categorized as hydropic ear diseases, radiological evidences demonstrate that MD patients exhibit inner ear anatomical variations, whereas no significant anatomical variations are observed in ALHL patients. This suggests that anatomical variations in the endolymphatic drainage system may be a predisposing factor for the pathogenesis of unilateral MD rather than for unilateral ALHL.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: This study aimed to evaluate phenotypic associations between preoperative alkaline phosphatase (ALP) levels and clinical characteristics, and explore clinical factors associated for postoperative regrowth in craniofacial fibrous dysplasia. Methods: In this retrospective cohort (2003-2024), 71 surgically treated fibrous dysplasia patients were analyzed. Relationships between preoperative ALP (using age-stratified reference ranges) and key phenotypes (age at surgery, onset age, laterality, lesion type) were assessed via nonparametric tests. Associations with postoperative regrowth were assessed using Mann-Whitney U or Kruskal-Wallis tests for non-normally distributed continuous variables and χ2 or Fisher's exact tests for categorical variables. Results: Preoperative ALP levels significantly correlated with younger surgical age (16-19 vs. ≥19 years: 244.0 vs. 107.0 U/L, p < 0.001), earlier onset (0-16 vs. >16 years: 114.0 vs. 83.0 U/L, p = 0.030), bilateral lesions (176.0 vs. 106.2 U/L, p = 0.006), and polyostotic subtype (polyostotic fibrous dysplasia vs. monostotic fibrous dysplasia: 162.0 vs. 87.5 U/L, p < 0.001). However, neither ALP levels (p = 0.061) nor abnormal ALP rates (p = 0.090) predicted regrowth. Crucially, bilateral lesions were significantly associated with regrowth (83.3% (5/6) vs. 21.5% (14/65); p = 0.005). The overall regrowth rate was 8.5% (6/71). Conclusions: Bilateral lesions demonstrate significant association with postoperative regrowth risk, potentially guiding surveillance intensity. ALP correlates with phenotypic burden but shows limited prognostic utility. These findings, interpreted considering retrospective constraints, warrant validation in larger cohorts.
目的：本研究旨在评估术前碱性磷酸酶（ALP）水平与临床特征之间的表型相关性，探讨颅面纤维发育不良术后再生的临床相关因素。方法：回顾性分析了71例手术治疗的纤维结构不良患者（2003-2024）。术前ALP（使用年龄分层参考范围）与关键表型（手术年龄、发病年龄、侧边性、病变类型）之间的关系通过非参数检验进行评估。对非正态分布连续变量采用Mann-Whitney U检验或Kruskal-Wallis检验，对分类变量采用χ2或Fisher精确检验，评估与术后再生的相关性。结果：术前ALP水平与较年轻的手术年龄（16-19岁vs≥19岁：244.0 vs 107.0 U/L, p < 0.001）、较早发病（0-16岁vs bbb16岁：114.0 vs 83.0 U/L, p = 0.030）、双侧病变（176.0 vs 106.2 U/L, p = 0.006）和多骨发育不良（多骨纤维发育不良vs单骨纤维发育不良：162.0 vs 87.5 U/L, p < 0.001）显著相关。然而，无论是ALP水平（p = 0.061）还是异常ALP率（p = 0.090）都不能预测再生。至关重要的是，双侧病变与再生显著相关(83.3%（5/6）对21.5% (14/65)；P = 0.005)。总再生速率为8.5%（6/71）。结论：双侧病变与术后再生风险显著相关，可能指导监测强度。ALP与表型负担相关，但预后作用有限。考虑到回顾性约束，这些发现有理由在更大的队列中得到验证。
{"title":"Bilateral Lesions Are Linked to Postoperative Regrowth in Craniofacial Fibrous Dysplasia: Alkaline Phosphatase as a Marker of Clinical Phenotype.","authors":"Jiang Xue, Longping Liu, Jianyun Zhang, Yue Lou, Lisha Sun, Tiejun Li","doi":"10.3390/diagnostics16030472","DOIUrl":"https://doi.org/10.3390/diagnostics16030472","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to evaluate phenotypic associations between preoperative alkaline phosphatase (ALP) levels and clinical characteristics, and explore clinical factors associated for postoperative regrowth in craniofacial fibrous dysplasia. <b>Methods:</b> In this retrospective cohort (2003-2024), 71 surgically treated fibrous dysplasia patients were analyzed. Relationships between preoperative ALP (using age-stratified reference ranges) and key phenotypes (age at surgery, onset age, laterality, lesion type) were assessed via nonparametric tests. Associations with postoperative regrowth were assessed using Mann-Whitney U or Kruskal-Wallis tests for non-normally distributed continuous variables and χ<sup>2</sup> or Fisher's exact tests for categorical variables. <b>Results:</b> Preoperative ALP levels significantly correlated with younger surgical age (16-19 vs. ≥19 years: 244.0 vs. 107.0 U/L, <i>p</i> < 0.001), earlier onset (0-16 vs. >16 years: 114.0 vs. 83.0 U/L, <i>p</i> = 0.030), bilateral lesions (176.0 vs. 106.2 U/L, <i>p</i> = 0.006), and polyostotic subtype (polyostotic fibrous dysplasia vs. monostotic fibrous dysplasia: 162.0 vs. 87.5 U/L, <i>p</i> < 0.001). However, neither ALP levels (<i>p</i> = 0.061) nor abnormal ALP rates (<i>p</i> = 0.090) predicted regrowth. Crucially, bilateral lesions were significantly associated with regrowth (83.3% (5/6) vs. 21.5% (14/65); <i>p</i> = 0.005). The overall regrowth rate was 8.5% (6/71). <b>Conclusions:</b> Bilateral lesions demonstrate significant association with postoperative regrowth risk, potentially guiding surveillance intensity. ALP correlates with phenotypic burden but shows limited prognostic utility. These findings, interpreted considering retrospective constraints, warrant validation in larger cohorts.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-02DOI: 10.3390/diagnostics16030464
Amir Shabtay, Iftach Sagy, Elizaveta Rabaev, Hezzy Shmueli, Leonid Barski
Background: SARS-CoV-2 infection, its late complications, and SARS-CoV-2 vaccines are known to cause pericardial effusion. We sought to investigate the influence of the COVID-19 outbreak on trends in pericardiocentesis. Methods: We performed a retrospective population study including all >18 years patients undergoing pericardiocentesis in a single tertiary hospital between January 2018 and April 2022. The effusion characteristics and patient outcomes were compared between patients admitted before and after the COVID-19 outbreak. Results: 92 patients underwent pericardiocentesis cases during the COVID-19 period compared to 65 patients during the pre-COVID-19 period (χ2 = 3.07, p = 0.0796). Only 15% of the post-COVID-19 outbreak cases were related to COVID-19 infection or vaccine. In-hospital mortality was numerically higher during the post-COVID-19 group (7.7% vs. 14.4%), but this difference did not reach statistical significance (p = 0.22). The 90-day mortality was also similar between groups. Conclusions: A numerical, yet statistically insignificant increase in pericardiocentesis was observed following the COVID-19 outbreak. We assume this observation cannot be attributed solely to the virus and vaccines per se. Neglect of other chronic diseases, social distancing, and widespread availability of point-of-care ultrasound may have contributed to this observation.
{"title":"The Influence of the COVID-19 Pandemic on Patients Admitted with Pericardial Effusion.","authors":"Amir Shabtay, Iftach Sagy, Elizaveta Rabaev, Hezzy Shmueli, Leonid Barski","doi":"10.3390/diagnostics16030464","DOIUrl":"https://doi.org/10.3390/diagnostics16030464","url":null,"abstract":"<p><p><b>Background</b>: SARS-CoV-2 infection, its late complications, and SARS-CoV-2 vaccines are known to cause pericardial effusion. We sought to investigate the influence of the COVID-19 outbreak on trends in pericardiocentesis. <b>Methods</b>: We performed a retrospective population study including all >18 years patients undergoing pericardiocentesis in a single tertiary hospital between January 2018 and April 2022. The effusion characteristics and patient outcomes were compared between patients admitted before and after the COVID-19 outbreak. <b>Results</b>: 92 patients underwent pericardiocentesis cases during the COVID-19 period compared to 65 patients during the pre-COVID-19 period (<i>χ</i><sup>2</sup> = 3.07, <i>p</i> = 0.0796). Only 15% of the post-COVID-19 outbreak cases were related to COVID-19 infection or vaccine. In-hospital mortality was numerically higher during the post-COVID-19 group (7.7% vs. 14.4%), but this difference did not reach statistical significance (<i>p</i> = 0.22). The 90-day mortality was also similar between groups. <b>Conclusions</b>: A numerical, yet statistically insignificant increase in pericardiocentesis was observed following the COVID-19 outbreak. We assume this observation cannot be attributed solely to the virus and vaccines per se. Neglect of other chronic diseases, social distancing, and widespread availability of point-of-care ultrasound may have contributed to this observation.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-02DOI: 10.3390/diagnostics16030462
Oana Maria Gorun, Adrian Ratiu, Florin Gorun, Cosmin Citu, Voicu Caius Simedrea, Daniela-Eugenia Popescu, Roxana Folescu, Andrei Motoc
Background: Predicting natural conception following surgical treatment remains a clinical challenge for endometriosis, a chronic inflammatory condition often associated with infertility. This study aimed to determine if simple, low-cost inflammatory biomarkers, such as NLR, dNLR, LMR, PLR, SIRI, PIV, and SII calculated from routine preoperative blood tests are associated with spontaneous pregnancy in women with endometriosis-related infertility after laparoscopic surgery. Methods: A retrospective analysis was conducted on 78 women between the ages of 18 and 48 who underwent standardized laparoscopic surgery and were monitored for up to 18 months. Results: The pregnancy group had significantly lower NLR, dNLR, PLR, SIRI, and especially SII values than the non-pregnancy group. Among the evaluated markers, SII, NLR, and dNLR demonstrated the highest discriminative ability for spontaneous conception. In regression analyses, lower values of NLR and dNLR were associated with higher odds of spontaneous pregnancy. Conclusions: These findings suggest a correlation between preoperative inflammatory status and postoperative reproductive outcomes in women with endometriosis.
{"title":"Association of Peripheral Inflammatory Markers with Conception Outcomes Among Women with Endometriosis-Associated Infertility.","authors":"Oana Maria Gorun, Adrian Ratiu, Florin Gorun, Cosmin Citu, Voicu Caius Simedrea, Daniela-Eugenia Popescu, Roxana Folescu, Andrei Motoc","doi":"10.3390/diagnostics16030462","DOIUrl":"https://doi.org/10.3390/diagnostics16030462","url":null,"abstract":"<p><p><b>Background:</b> Predicting natural conception following surgical treatment remains a clinical challenge for endometriosis, a chronic inflammatory condition often associated with infertility. This study aimed to determine if simple, low-cost inflammatory biomarkers, such as NLR, dNLR, LMR, PLR, SIRI, PIV, and SII calculated from routine preoperative blood tests are associated with spontaneous pregnancy in women with endometriosis-related infertility after laparoscopic surgery. <b>Methods</b>: A retrospective analysis was conducted on 78 women between the ages of 18 and 48 who underwent standardized laparoscopic surgery and were monitored for up to 18 months. <b>Results</b>: The pregnancy group had significantly lower NLR, dNLR, PLR, SIRI, and especially SII values than the non-pregnancy group. Among the evaluated markers, SII, NLR, and dNLR demonstrated the highest discriminative ability for spontaneous conception. In regression analyses, lower values of NLR and dNLR were associated with higher odds of spontaneous pregnancy. <b>Conclusions</b>: These findings suggest a correlation between preoperative inflammatory status and postoperative reproductive outcomes in women with endometriosis.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146176900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-02DOI: 10.3390/diagnostics16030465
Necim Yalcin, Aysun Alci, Mustafa Gokkaya, Mehmet Goksu, Tayfun Toptas, Isin Ureyen
Objectives: The main objective of the present study was to evaluate the outcomes of patients referred for colposcopy due to human papillomavirus (HPV) positivity and/or abnormal cytology. Methods: A retrospective analysis was conducted on women who underwent colposcopy between January 2015 and December 2023. Demographic data and results of the colposcopy result were obtained from the patient files and the electronic gynecologic oncology clinic database. Results: A total of 2682 patients were included in the analysis. A cervical biopsy identified a cervical intraepithelial neoplasia (CIN)2+ (CIN2, CIN3, and invasive cancer) lesions in 361 patients (13.5%), while endocervical curettage (ECC) identified a CIN2+ lesions in 148 patients (5.6%). A total of 74 patients exhibited CIN2+ lesions in both cervical biopsy and ECC samples, while 74 patients displayed CIN2+ lesions exclusively in ECC samples. The distribution of high-risk HPV positivity in 435 patients with CIN2+ lesions revealed that 47.5% of patients were positive for HPV type 16, while 8.9% were positive for HPV type 18. A total of 50% of all patients diagnosed with CIN2+ lesions by ECC alone were found to be positive for HPV type 16 (37/74). Of the 116 patients with high-risk HPV positivity and normal cytology, 34 (29.3%) were high-risk HPV other-positive. Conclusion: HPV type 16 and 18 positivity represents the highest-risk groups in terms of CIN2+ lesion development. ECC should be considered, in particular, in women with HPV 16 positivity. Colposcopy should be performed immediately, rather than after one year, in women with high-risk HPV other-positivity and normal cervical cytology, in order to increase the detection rate of CIN2+ lesions.
{"title":"Evaluation of the Outcomes of Patients Undergoing Colposcopy for High-Risk Human Papillomavirus Positivity and/or Abnormal Cervical Cytology.","authors":"Necim Yalcin, Aysun Alci, Mustafa Gokkaya, Mehmet Goksu, Tayfun Toptas, Isin Ureyen","doi":"10.3390/diagnostics16030465","DOIUrl":"https://doi.org/10.3390/diagnostics16030465","url":null,"abstract":"<p><p><b>Objectives:</b> The main objective of the present study was to evaluate the outcomes of patients referred for colposcopy due to human papillomavirus (HPV) positivity and/or abnormal cytology. <b>Methods:</b> A retrospective analysis was conducted on women who underwent colposcopy between January 2015 and December 2023. Demographic data and results of the colposcopy result were obtained from the patient files and the electronic gynecologic oncology clinic database. <b>Results:</b> A total of 2682 patients were included in the analysis. A cervical biopsy identified a cervical intraepithelial neoplasia (CIN)2+ (CIN2, CIN3, and invasive cancer) lesions in 361 patients (13.5%), while endocervical curettage (ECC) identified a CIN2+ lesions in 148 patients (5.6%). A total of 74 patients exhibited CIN2+ lesions in both cervical biopsy and ECC samples, while 74 patients displayed CIN2+ lesions exclusively in ECC samples. The distribution of high-risk HPV positivity in 435 patients with CIN2+ lesions revealed that 47.5% of patients were positive for HPV type 16, while 8.9% were positive for HPV type 18. A total of 50% of all patients diagnosed with CIN2+ lesions by ECC alone were found to be positive for HPV type 16 (37/74). Of the 116 patients with high-risk HPV positivity and normal cytology, 34 (29.3%) were high-risk HPV other-positive. <b>Conclusion:</b> HPV type 16 and 18 positivity represents the highest-risk groups in terms of CIN2+ lesion development. ECC should be considered, in particular, in women with HPV 16 positivity. Colposcopy should be performed immediately, rather than after one year, in women with high-risk HPV other-positivity and normal cervical cytology, in order to increase the detection rate of CIN2+ lesions.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号