scholarly journals Metabolomics improves the histopathological diagnosis of asphyxial deaths: an animal proof-of-concept model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Emanuela Locci ◽  
Alberto Chighine ◽  
Antonio Noto ◽  
Giulio Ferino ◽  
Alfonso Baldi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clear Correlation ◽  
Swine Model ◽  
Histopathological Diagnosis ◽  
Additional Information ◽  
Concept Model ◽  
Objective Evidence ◽  
Comparative Results ◽  
Poor Outcomes ◽  
Mechanical Asphyxia

AbstractThe diagnosis of mechanical asphyxia remains one of the most difficult issues in forensic pathology. Asphyxia ultimately results in cardiac arrest (CA) and, as there are no specific markers, the differential diagnosis of primitive CA and CA secondary to asphyxiation relies on circumstantial details and on the pathologist experience, lacking objective evidence. Histological examination is currently considered the gold standard for CA post-mortem diagnosis. Here we present the comparative results of histopathology versus those previously obtained by 1H nuclear magnetic resonance (NMR) metabolomics in a swine model, originally designed for clinical purposes, exposed to two different CA causes, namely ventricular fibrillation and asphyxia. While heart and brain microscopical analysis could identify the damage induced by CA without providing any additional information on the CA cause, metabolomics allowed the identification of clearly different profiles between the two groups and showed major differences between asphyxiated animals with good and poor outcomes. Minute-by-minute plasma sampling allowed to associate these modifications to the pre-arrest asphyxial phase showing a clear correlation to the cellular effect of mechanical asphyxia reproduced in the experiment. The results suggest that metabolomics provides additional evidence beyond that obtained by histology and immunohistochemistry in the differential diagnosis of CA.

scholarly journals Diagnostic value of magnetic resonance imaging in the analysis of ameloblastoma: report of two cases

2019 ◽  
Vol 22 (3) ◽  
pp. 425-431
Author(s):  
Neiandro Santos Galvão ◽  
Antonione Santos Bezerra Pinto ◽  
Alan Leandro Carvalho Farias ◽  
André Luiz Ferreira Costa ◽  
Sérgio Lúcio Pereira de Castro Lopes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Intermediate Signal Intensity ◽  
Additional Information ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

Ameloblastoma is an odontogenic tumor that shares clinical and imaging characteristics with other lesions of the jaws, such as odontogenic keratocyst, which makes the diagnosis difficult. However, in addition to radiographic and tomographic examinations, Magnetic Resonance Imaging (MRI) has been increasingly used, contributing with relevant additional information about the differentiation between solid and liquid components of the lesion. This case report was conducted to present two variations of ameloblastoma and discuss the radiographic, tomographic and MRI contribution in the differential diagnosis between ameloblastoma and odontogenic keratocyst.The signal intensity in T1-weighted MRI revealed internal fluid content in both cases, which was important in the differential diagnosis with other intraosseous lesions such as odontogenic keratocysts. This is probably due to the presence of keratin that increases the viscosity of the content and also for an intermediate signal intensity signal in T2-weighted MRI. Therefore, MRI revealed important internal characteristics of the reported lesions, which was very useful in the establishment of the differential diagnosis with other lesions.

Abstract 108: Additional Value of Intracranial Vessel Wall Imaging to Determine the Etiology of Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joanna D Schaafsma ◽  
David J Mikulis ◽  
Jonathan Coutinho ◽  
Cheryl S Jaigobin ◽  
Daniel M Mandell
Keyword(s):  
Differential Diagnosis ◽  
Ischemic Stroke ◽  
Vessel Wall ◽  
Stroke Work ◽  
Standard Work ◽  
Additional Information ◽  
Stroke Etiology ◽  
Additional Value ◽  
Work Up ◽  
Wall Imaging

Objective: High-resolution MR-imaging of the intracranial arterial wall is a promising technique for diagnosis of intracranial arteriopathies in patients with ischemic stroke. We aimed to evaluate the additional value of vessel wall imaging (VWI) to the standard work-up of ischemic stroke patients. Methods: We selected all patients with ischemic stroke who had intracranial VWI at our institute to evaluate possible intracranial arteriopathy, such as atherosclerosis, dissection, vasculitis, or reversible cerebral vasoconstriction syndrome. Two observers, who were blinded to the VWI, first determined the most likely stroke etiology based on the standard work-up (clinical history, brain parenchyma imaging, vessel lumen imaging, laboratory results, and cardiac work-up). Then VWI was reviewed to assess whether this would change the suspected stroke etiology or whether the differential diagnosis could be narrowed down. Results: Between 2006 and 2014, 199 patients with ischemic stroke, mean age 55 (IQ-range: 44-67) had VWI. VWI provided additional information to the standard stroke work-up in 128 patients (64%). In 38/199 patients (19%) the conclusion on stroke etiology was altered based on VWI and in 90/199 patients (45%) the differential diagnosis was further narrowed after VWI. VWI did not have additional value when the most likely stroke etiology based on the standard work-up remained the same (50/199 patients; 25%), when the differential diagnosis could not be narrowed down (16/199; 8%), or in case of poor image quality (5/199 patients; 3%). Patients under the age of 46 benefited more often from VWI than older adults (Odds Ratio 3.5; 95%CI: 1.7-7.6). Conclusion: VWI provided additional information to the conventional stroke work-up in almost two-thirds of patients suspected to have intracranial arteriopathy. Next step is to determine how frequently this additional information resulted in altered therapy.

Utilizing CT soft-tissue markers as a screening tool for acute invasive fungal sinusitis

2021 ◽  
Author(s):  
Deepa Susan John ◽  
Karthik Shyam ◽  
Dhilip Andrew ◽  
Soumya Cicilet ◽  
Saikanth Reddy Deepalam
Keyword(s):  
Soft Tissue ◽  
Early Detection ◽  
Nasolacrimal Duct ◽  
Histopathological Diagnosis ◽  
Fungal Sinusitis ◽  
Equal Distribution ◽  
Early Therapy ◽  
Invasive Fungal Sinusitis ◽  
Poor Outcomes ◽  
Contrast Ct

Objectives: Acute invasive fungal sinusitis (AIFS) is a rapidly progressive disease, whose delayed identification results in poor outcomes, especially in immunocompromised individuals. A surge in of AIFS in the wake of the COVID-19 pandemic, has lent additional morbidity and mortality to an already precarious clinical scenario. Early detection of AIFS in individuals who are symptomatic/ at risk can allow early therapy, enabling better patient outcomes. Our study aims to determine optimal soft-tissue markers on CT for the early detection of AIFS. Methods: In this case-control study, 142 patients with equal distribution of subjects were chosen based on histopathological diagnosis of AIFS; and their non-contrast CT scans were retrospectively assessed to determine the diagnostic utility of specific soft-tissue markers that would enable diagnosis of AIFS. Results: A total of 9 markers with adequate sensitivity and specificity were identified, including pterygopalatine and sphenopalatine fossae, inferior orbital fissure and nasolacrimal duct involvement, premaxillary thickening, retro-antral and orbital stranding, and infratemporal muscle edema. It was determined that the combined occurrence of any 3 out of 9 markers was 91.5% sensitive and 95.9% specific for diagnosis of AIFS (p < 0.005). Conclusion: Early, accurate detection of AIFS in predisposed individuals is possible with identification of soft-tissue markers on NECT, enabling early intervention. Advances in knowledge: Being the aggressive disease that it is, AIFS may be managed early if the index of suspicion is held high via CT imaging; which our diagnostic checklist aims at enabling.

Correlation of quantitative p95HER2, HER2, and HER3 protein expression with pathologic complete response (pCR) in HER2-positive breast cancer patients (pts) treated with neoadjuvant chemotherapy and trastuzumab.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 137-137 ◽  
Author(s):  
Jose Caetano Villasboas ◽  
Judith Hurley ◽  
Jodi Marie Weidler ◽  
Agnes Paquet ◽  
Carmen Gomez Fernandez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pathologic Complete Response ◽  
Metastatic Breast ◽  
Complete Response ◽  
Invasive Disease ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Additional Information ◽  
Her2 Breast Cancer ◽  
Poor Outcomes

137 Background: Elevated p95HER2 [HER2-M611-CTF (carboxy-terminal-fragment) also known as p95] expression has been correlated with poor outcomes in HER2+ pts with metastatic breast cancer treated with trastuzumab (T); however, limited data is available on the correlation between p95 and pCR to T in the neoadjuvant (NEO) setting, where p95 was measured by immunohistochemistry. The current study aims to determine whether quantitative p95, HER3 and HER2 expression correlated with pCR in pts treated with T + chemotherapy in the NEO setting. Methods: pCR data and quantitative HER2 (H2T), p95, and HER3 (H3T) results by HERmark/VeraTag assays were available in 45 patient cases with pre-therapy, formalin-fixed, paraffin-embedded breast tumors. pCR was defined as the absence of invasive disease in the breast. Quantitative biomarker data were correlated with pCR according to previously published or presented biomarker cutoffs. Results: The overall pCR rate was 46.7% (ER+: 14.3% vs. ER-: 75%; p<0.0001) and was significantly associated with higher H2T levels (p=0.02) and lower H3T levels (p=0.04). In ER- subjects (N=24), no difference in H2T levels was observed between pCR vs non-pCR groups (median H2T=111.5 vs 150.5, respectively; p=0.721). However, within the ER+ group (N=21), H2T levels were significantly higher in the pCR group vs non-pCR group (median H2T=254 vs 37.3; p=0.024). Using multivariate logistic regression, increasing log(H2T) (p = 0.012), ER-negativity (p = 0.027) and low p95 (p = 0.074) were found to correlate or trend with pCR. Conclusions: pCR was significantly associated with high H2T, particularly in ER+ HER2+ breast cancer pts who received NEO therapy with T + chemotherapy. Lower H3T was also associated with pCR. A trend towards pCR was seen in tumors with low p95. These data suggest that quantitative H2T, H3T and p95 may provide additional information on response to T-based regimens in breast cancer stratified by ER status. Additional investigation into the relationship between quantitative H2T, p95 and H3T expression and T response in the NEO setting in larger cohorts is warranted.

scholarly journals Seminoma, Sertolioma, and Leydigoma in Dogs: Clinical and Morphological Correlations

2012 ◽  
Vol 56 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Rafał Ciaputa ◽  
Marcin Nowak ◽  
Maciej Kiełbowicz ◽  
Agnieszka Antończyk ◽  
Karolina Błasiak ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Sertoli Cells ◽  
Leydig Cells ◽  
Histopathological Diagnosis ◽  
Biochemical Tests ◽  
Ki 67 ◽  
X Ray ◽  
Testicular Tumours ◽  
Ray Patterns

Abstract The study aimed at presenting the most frequent male gonadal tumours in dogs, their clinical and histopathological aspects, at outlining aetiopathogenesis and differential diagnosis of the tumours. As examples of the most frequently manifested testicular tumours, three clinical cases were presented, involving tumour of interstitial (Leydig) cells, tumour of Sertoli cells, and seminoma. Respective clinical diagnosis employed USG, X-ray patterns, and morphological and biochemical tests. The surgically sampled material was stained with H+E and an attempt was made to establish expression of E-cadherin, calretinin, and Ki-67. It was shown that histopathological diagnosis of testicular tumours in dogs is frequently very difficult and complex and requires multidirectional studies.

scholarly journals Postmortem Traumatic Lesions Produced In Storm Conditions In Black Sea – Case Presentations

2012 ◽  
Vol 18 (1) ◽  
pp. 46-49
Author(s):  
Marius Florentin Popa
Keyword(s):  
Differential Diagnosis ◽  
Black Sea ◽  
Forensic Pathology ◽  
Violent Death ◽  
Traumatic Injuries ◽  
Traumatic Lesions ◽  
Fluid Environment ◽  
Case Presentations ◽  
Mechanical Asphyxia

Abstract Drowning represents a mechanical asphyxia form, produced by the obstruction of the air pathways, obstruction in which the air is replaced by a fluid. For the drowning to take place is enough that the breathing orifices (mouth, nose) to be placed in the fluid environment. This paper aims to analyze some special drowning cases, cases in which the traumatic lesions encountered are very rare in the forensic pathology. These postmortem traumatic lesions are very rare encountered in cases of drowning. In the international special literature there are no such cases presented, because these types of traumatic injuries are usually present in death situations due to a much more violent death mechanism - blunt object trauma, driving or train accidents. In the international special literature this types of lesions are not encountered, this aspect being very important to be known and noted, for a pertinent differential diagnosis with other more violent types of death.

scholarly journals Clinical Manifestations of Parkinson's Disease and Parkinsonism

2003 ◽  
Vol 30 (S1) ◽  
pp. S2-S9 ◽  
Author(s):  
Doug Everett Hobson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Differential Diagnosis ◽  
Multiple System Atrophy ◽  
Dementia With Lewy Bodies ◽  
Clinical Manifestations ◽  
Lewy Bodies ◽  
Accurate Diagnosis ◽  
Additional Information ◽  
Diagnosis And Prognosis

The most common disorder in a patient presenting to a movement disorder clinic will be parkinsonism. The challenge is to provide the patient with the most accurate diagnosis and prognosis possible. The assumption at the time of initial presentation of the clinical diagnosis of Parkinson's disease is often wrong (20-25%). Waiting to see the pattern of progression, and response to medication provides invaluable additional information. This manuscript summarizes the clinical manifestations of Parkinson's disease and the main akinetic-rigid syndromes (progressive supranuclear palsy, multiple system atrophy, cortical-basal ganglionic degeneration, and dementia with Lewy bodies) that make up the differential diagnosis.

scholarly journals The Use of Statistical Parametric Mapping (SPM96) as a Decision Aid in the Differential Diagnosis of Dementia Using99mTc-HMPAO SPECT

2000 ◽  
Vol 12 (1-2) ◽  
pp. 77-86 ◽  
Author(s):  
A. Barnes ◽  
D. Lusman ◽  
J. Patterson ◽  
D. Brown ◽  
D. Wyper
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Decision Aid ◽  
Statistical Parametric Mapping ◽  
Clinical Environment ◽  
Additional Information ◽  
Hmpao Spect ◽  
Diagnosis Of Dementia ◽  
Image Reporting ◽  
Differential Diagnosis Of Dementia

In this study standard patterns of cerebral perfusion based on classifications described in the literature have been chosen and the ability of experienced imaging specialists to categorise the99mTc HMPAO SPECT scans of patients referred to the department for investigation of dementia has been compared before and after the calculation of Statistical Parametric Maps (SPM—Wellcome Dept of Cognitive Neurology). The primary aim was to investigate whether SPM is an effective decision aid and whether it impacts on the confidence of image reporting. The secondary aim was to examine the influence of SPM on the agreement between image reporting and clinical diagnosis. The results showed that there was a slight decrease in agreement between the imaging specialists after the introduction of additional information from SPM (K= 0.57 toK= 0.5) and that agreement between imaging reporting (including information from SPM) and clinical diagnosis was moderate (K= 0.28). This study was able to confirm that SPM is capable of producing meaningful significance maps of individual patients in a routine clinical environment. However, there was no overwhelming evidence that SPM was able to resolve many of the dilemmas associated with the use of SPECT for the differential diagnosis of dementia. In particular, interpretation of SPECT perfusion patterns in dementia is a bigger problem than the initial identification of abnormalities.

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