scholarly journals Is the Adenosine Test Obsolete in the Clinical Assessment of Syncope of Unknown Origin?

2021 ◽  
Vol 10 (4) ◽  
pp. 230-234
Author(s):  
Melani Sotiriadou ◽  
Antonios P Antoniadis ◽  
Nikolaos Fragakis ◽  
Vassilios Vassilikos
Keyword(s):  
Unknown Origin ◽  
Accurate Diagnosis ◽  
Future Perspectives ◽  
Pathogenetic Mechanism ◽  
Non Invasive ◽  
Invasive Test ◽  
Underlying Mechanisms ◽  
European Society Of Cardiology ◽  
Work Up

Syncope is a common clinical condition affecting 50% of the general population; however, its exact pathophysiology and underlying mechanisms remain elusive. The adenosine test (ADT) has been proposed as a complementary diagnostic test in the work-up of syncope of unknown origin aiming to further elucidate the underlying pathogenetic mechanism of spontaneous syncope. Although ADT has not been endorsed by the recent European Society of Cardiology guidelines on syncope management, the use of a quick, safe and non-invasive test which can contribute to an accurate diagnosis and rationalised therapy, may deserve further consideration. This review summarises the evidence on the role of ADT in the investigation and management of syncope of unknown origin and highlights future perspectives in this area. The authors also analyse the current challenges and research targets on adenosine plasma levels and its receptors due to the involvement of the adenosine pathway in the ADT response.

scholarly journals Identification of Potential Diagnostic and Prognostic Biomarkers for Colorectal Cancer Based on GEO and TCGA Databases

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhenjiang Wang ◽  
Mingyi Guo ◽  
Xinbo Ai ◽  
Jianbin Cheng ◽  
Zaiwei Huang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Interaction Network ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Prognostic Biomarkers ◽  
High Recurrence Rate ◽  
Mortality And Morbidity ◽  
Invasive Test ◽  
Underlying Mechanisms

Colorectal cancer (CRC) is one of the most common neoplastic diseases worldwide. With a high recurrence rate among all cancers, treatment of CRC only improved a little over the last two decades. The mortality and morbidity rates can be significantly lessened by earlier diagnosis and prompt treatment. Available biomarkers are not sensitive enough for the diagnosis of CRC, whereas the standard diagnostic method, endoscopy, is an invasive test and expensive. Hence, seeking the diagnostic and prognostic biomarkers of CRC is urgent and challenging. With that order, we screened the overlapped differentially expressed genes (DEGs) of GEO (GSE110223, GSE110224, GSE113513) and TCGA datasets. Subsequent protein–protein interaction network analysis recognized the hub genes among these DEGs. Further functional analyses including Gene Ontology and KEGG pathway analysis and gene set enrichment analysis were processed to investigate the role of these genes and potential underlying mechanisms in CRC. Kaplan–Meier analysis and Cox hazard ratio analysis were carried out to clarify the diagnostic and prognostic role of these genes. In conclusion, our present study demonstrated that CCNA2, MAD2L1, DLGAP5, AURKA, and RRM2 are all potential diagnostic biomarkers for CRC and may also be potential treatment targets for clinical implication in the future.

scholarly journals Case Report: SARS-CoV-2 as an unexpected causal agent of isolated febrile hepatitis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 400
Author(s):  
Paraskevas Filippidis ◽  
Francois van Ouwenaller ◽  
Alberto Cerutti ◽  
Anaïs Geiger-Jacquod ◽  
Christine Sempoux ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Unknown Origin ◽  
Causal Agent ◽  
Nasopharyngeal Swab ◽  
Serological Testing ◽  
Case Presentation ◽  
Pcr Screening ◽  
Work Up

Background: Respiratory symptoms and pneumonia are the predominant features of Coronavirus disease 2019 (COVID-19) due to emerging SARS-CoV-2 virus, but extrapulmonary manifestations are also observed. For instance, some degree of liver injury has been described among patients requiring hospital admission for severe COVID-19. However, acute febrile hepatitis as an initial or predominant manifestation of COVID-19 has been rarely reported. Case presentation: A 34-year-old man without underlying medical conditions presented with fever of unknown origin for two weeks in the absence of respiratory symptoms or other complaints. Laboratory testing revealed isolated acute hepatitis, for which an extensive microbiological work-up did not reveal identification of the causal agent. PCR testing for SARS-CoV-2 on a nasopharyngeal swab was negative on two occasions and initial serology for SARS-CoV-2 (at 15 days from symptoms onset) was also negative. However, repeated SARS-CoV-2 serological testing at 30 days demonstrated seroconversion leading to the diagnosis of COVID-19-related hepatitis. The patient's condition progressively improved, while transaminases steadily declined and eventually returned back to normal within 30 days. Conclusions: We describe here a unique case of SARS-CoV-2 isolated febrile hepatitis in a young and previously healthy man, which was diagnosed by demonstration of seroconversion, while PCR screening was negative. This case report highlights the role of repeated serological testing for the diagnosis of extrapulmonary manifestations of COVID-19.

scholarly journals Case Report: SARS-CoV-2 as an unexpected causal agent of predominant febrile hepatitis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 400
Author(s):  
Paraskevas Filippidis ◽  
Francois van Ouwenaller ◽  
Alberto Cerutti ◽  
Anaïs Geiger-Jacquod ◽  
Christine Sempoux ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Unknown Origin ◽  
Causal Agent ◽  
Nasopharyngeal Swab ◽  
Serological Testing ◽  
Case Presentation ◽  
Pcr Screening ◽  
Work Up

Background: Respiratory symptoms and pneumonia are the predominant features of Coronavirus disease 2019 (COVID-19) due to emerging SARS-CoV-2 virus, but extrapulmonary manifestations are also observed. For instance, some degree of liver injury has been described among patients requiring hospital admission for severe COVID-19. However, acute febrile hepatitis as an initial or predominant manifestation of COVID-19 has been rarely reported. Case presentation: A 34-year-old man without underlying medical conditions presented with fever of unknown origin for two weeks in the absence of respiratory symptoms or other complaints. Laboratory testing revealed isolated acute hepatitis, for which an extensive microbiological work-up did not reveal identification of the causal agent. PCR testing for SARS-CoV-2 on a nasopharyngeal swab was negative on two occasions and initial serology for SARS-CoV-2 (at 15 days from symptoms onset) was also negative. However, repeated SARS-CoV-2 serological testing at 30 days demonstrated seroconversion leading to the diagnosis of COVID-19-related hepatitis. The patient's condition progressively improved, while transaminases steadily declined and eventually returned back to normal within 30 days. Conclusions: We describe here a unique case of SARS-CoV-2 isolated febrile hepatitis in a young and previously healthy man, which was diagnosed by demonstration of seroconversion, while PCR screening was negative. This case report highlights the role of repeated serological testing for the diagnosis of extrapulmonary manifestations of COVID-19.

The Role of Musculoskeletal USG as Diagonostic Tool of CTS

2014 ◽  
Vol 25 (2) ◽  
pp. 44-49
Author(s):  
P Das ◽  
R Pramanik ◽  
M Kataruka ◽  
RN Haldar ◽  
S Samanta ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Predictive Value ◽  
Low Cost ◽  
Large Population ◽  
Study Data ◽  
Cross Sectional ◽  
Non Invasive ◽  
Invasive Test ◽  
Kappa Value

Abstract Introduction Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS. Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study. Methodology After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG). Results At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG. Conclusion USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.

Role of Non-invasive Imaging in the Work-Up of Cardiomyopathies

2015 ◽  
Vol 17 (3) ◽  
Author(s):  
Lakshmi S. Tummala ◽  
Raymond K. Young ◽  
Tania Singh ◽  
Sandeep Jani ◽  
Monvadi B. Srichai
Keyword(s):  
Non Invasive ◽  
Work Up

scholarly journals Molecular detection of Mycobacterium tuberculosis in pulmonary and extrapulmonary samples in a hospital-based study

2020 ◽  
Vol 20 (4) ◽  
pp. 1617-23
Author(s):  
Kalal Iravathy Goud ◽  
Matam Kavitha ◽  
Adi Mahalakshmi ◽  
Ravi Vempati ◽  
Abdulaziz A Alodhayani ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pcr Analysis ◽  
Sequencing Analysis ◽  
Rt Pcr ◽  
Tissue Samples ◽  
Non Invasive ◽  
Invasive Test ◽  
Keywords Tuberculosis ◽  
Bronchoalveolar Fluid

Objective: Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a deadly infectious disease. India contributes to one-third of the global TB burden. However, no studies have been carried out in the Telangana (Hyderabad) population using real-time polymerase chain reaction (RT-PCR). Therefore, the current study evaluated the role of RT-PCR as a rapid and non-invasive test to diagnose TB by testing for pulmonary tuberculosis (PTB) and extrapulmonary tubercu- losis (EPTB). Materials and methods: This hospital-based study examined 1670 samples (900 EPTB; 770 PTB) comprising tissue (n = 537), peritoneal fluid (n = 420), sputum (n = 166), bronchial fluid (n = 126), cerebrospinal fluid (n = 145), ascetic fluid (n = 76), sputum pus (n = 78), urine (n = 79), and bronchoalveolar fluid (n = 43) samples. DNA from samples was separated using specific isolation kits and subjected to RT-PCR. Results: In this study, we enrolled 1670 subjects and categorized 54.4% as females and 45.6% as males. The collected sam- ples were categorized as 48.5% of fluid samples, followed by tissue (32.2%), sputum (9.9%), urine (4.7%), and pus-swab (4.6%). RT-PCR analysis revealed that 4.7% patients were positive for Mtb. Our results revealed that 61% of the affected patients were male and 39% were female. Among the specimen types, tissue samples gave the highest proportion of positive results (36.3%). Conclusion: The results showed that RT-PCR should be implemented and given top priority in TB diagnosis to save time and facilitate a definitive diagnosis. Tissue samples are highly recommended to screen the Mtb through the technique RT- PCR. Future studies should extend the technique to the global population and exome sequencing analysis should be per- formed to identify TB risk markers. Keywords: Tuberculosis (TB); EPTB; PTB; Mycobacterium tuberculosis (Mtb).

scholarly journals The Role of Invasive and Non-Invasive Procedures in Diagnosing Fever of Unknown Origin

2012 ◽  
Vol 9 (8) ◽  
pp. 682-689 ◽  
Author(s):  
Bilgul Mete ◽  
Ersin Vanli ◽  
Mucahit Yemisen ◽  
Ilker Inanc Balkan ◽  
Hilal Dagtekin ◽  
...  
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Invasive Procedures ◽  
Non Invasive

Role of Inflammation in Benign Gynecologic Disorders: From Pathogenesis to Novel Therapies

2021 ◽  
Author(s):  
Abdelrahman AlAshqar ◽  
Lauren Reschke ◽  
Gregory W Kirschen ◽  
Mostafa A Borahay
Keyword(s):  
Uterine Leiomyoma ◽  
Reproductive Tract ◽  
Gynecologic Malignancies ◽  
Systemic Complications ◽  
Therapeutic Implications ◽  
Non Invasive ◽  
Complex Interactions ◽  
Underlying Mechanisms ◽  
Invasive Techniques

Abstract Emerging evidence supports the notion that inflammation fosters the development of common benign gynecologic disorders, including uterine leiomyoma, endometriosis, and adenomyosis. Numerous cytokines, chemokines, and growth and transcription factors have indisputable roles in the establishment and maintenance of benign gynecologic disorders by initiating complex cascades that promote proliferation, angiogenesis, and lesion progression. The interaction between inflammation and benign gynecologic disorders is orchestrated by a plethora of factors, including sex steroids, genetics, epigenetics, extracellular matrix, stem cells, cardiometabolic risk factors, diet, vitamin D, and the immune system. The role of inflammation in these disorders is not limited to local pathobiology but also extends to involve clinical sequelae that range from those confined to the reproductive tract, such as infertility and gynecologic malignancies, to systemic complications such as cardiovascular disease. Enhanced understanding of the intricate mechanisms of this association will introduce us to unvisited pathophysiological perspectives and guide future diagnostic and therapeutic implications aimed at reducing the burden of these disorders. Utilization of inflammatory markers, microRNA, and molecular imaging as diagnostic adjuncts may be valuable, non-invasive techniques for prompt detection of benign gynecologic disorders. Further, use of novel as well as previously established therapeutics, such as immunomodulators, hormonal treatments, cardiometabolic medications, and cyclooxygenase-2 and NF-κB inhibitors, can target inflammatory pathways involved in their pathogenesis. In this comprehensive review, we aim to dissect the existing literature on the role of inflammation in benign gynecologic disorders, including the proposed underlying mechanisms and complex interactions, its contribution to clinical sequelae, and the clinical implications this role entails.

scholarly journals Pulmonary Hypertension in Patients With Heart Failure With Mid-Range Ejection Fraction

2021 ◽  
Vol 8 ◽  
Author(s):  
Micha T. Maeder ◽  
Lukas Weber ◽  
Marc Buser ◽  
Roman Brenner ◽  
Lucas Joerg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Non Invasive ◽  
Patients With Heart Failure ◽  
Underlying Mechanisms

Pulmonary hypertension (PH) is common in patients with heart failure (HF). The role of PH in patients with HF with reduced (HFrEF) and preserved (HFpEF) left ventricular ejection fraction (LVEF) has been extensively characterized during the last years. In contrast, the pathophysiology of HF with mid-range LVEF (HFmrEF), and in particular the role of PH in this context, are largely unknown. There is a paucity of data in this field, and the prevalence of PH, the underlying mechanisms, and the optimal therapy are not well-defined. Although often studied together there is increasing evidence that despite similarities with both HFrEF and HFpEF, HFmrEF also differs from both entities. The present review provides a summary of the current concepts of the mechanisms and clinical impact of PH in patients with HFmrEF, a proposal for the non-invasive and invasive diagnostic approach required to define the pathophysiology of PH and its management, and a discussion of future directions based on insights from mechanistic studies and randomized trials. We also provide an outlook regarding gaps in evidence, future clinical challenges, and research opportunities.

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