Transcriptomic Fingerprint of Bacterial Infection in Lower Extremity Ulcers

Clinicians and researchers utilize subjective classification systems based on clinical parameters to stratify lower extremity ulcer infections for treatment and research. This study compared clinical infection classifications (mild to severe) of lower extremity ulcers (n = 44) with transcriptomic profiles and direct measurement of bacterial RNA signatures by RNA-sequencing. Samples demonstrating similar transcriptomes were clustered and characterized by transcriptomic fingerprint. Clinical infection severity did not explain the major sources of variability among the samples and samples with the same clinical classification demonstrated high inter-sample variability. High proportions of bacterial RNA, however, resulted in a strong effect on transcription and increased expression of genes associated with immune response and inflammation. K-means clustering identified two clusters of samples, one of which contained all of the samples with high levels of bacterial RNA. A support vector classifier identified a fingerprint of 20 genes, including immune-associated genes such as CXCL8, GADD45B, and HILPDA, which accurately identified samples with signs of infection via cross-validation. This suggests that stratification of infection states based on a transcriptomic fingerprint may be a useful tool for studying host-bacterial interactions in these ulcers, as well as an objective classification method to identify the severity of infection.

Revisiting the question of psoriasis classification

Currently there are a large number of psoriasis classifications, slightly different from each other, used worldwide. Some of these classifications contain the disease forms allocated descriptively, without the pathogenesis characteristics in their basis. Among the dermatologists, there is lack of common understanding of various psoriasis forms peculiarities. And that affects both the diagnostic process and the approaches to therapy. The authors propose a revised unified clinical classification of psoriasis, including psoriatic arthritis. This method reflects the up-to-date view on the classification of psoriasis in Russia and globally.

Rhabdomyomatous Mesenchymal Hamartoma: A New Proposed Clinical Classification of Adult Onset Acquired Type

is missing (Short communication)

A Funhouse Mirror: Muscular Co-Contractions as a Reflection of a Spontaneous Aberrant Regeneration of the Brachial Plexus Injury in the Adults: Anatomical Background, an Attempt to Classify and their Clinical Relevance within the Reconstruction Strategies

A certain number of spontaneously recovering birth injuries to the brachial (BPI) plexus are known to be accompanied by muscle co-contractions (Co-Cs). The process of aberrant spontaneous regeneration contributes to the appearance of this phenomenon. Treatment strategies are mostly narrowed down to temporarily “switching off” the antagonist, allowing the agonist to perform. Less is known about the incidence of BPI-associated Co-Cs in adults (a-BPI), the control of which mainly presumes the extrapolation of a treatment strategy that has been shown to be effective in infants. Nowadays, surgical reconstruction of independent elbow flexion at BPIs relies heavily on redirection (transfer) of nerves that produce their own Co-Cs. These induced Co-Cs could potentially be reduced. Selecting the appropriate nerve transfer strategy (when the donor pool is narrowing), with its potential impact on the already complex and intricate global and segmental biomechanics of the upper extremity, becomes challenging. The chapter presents the anatomical background for the occurrence of muscular Co-Cs, a work on clinical classification of both regeneration associated and induced Co-Cs, possible surgical strategies, their benefits and limitations, in the presence of regeneration-associated muscle Co-Cs at a-BPI and clinical examples.

Breast Cancer Cell Subtypes Display Different Metabolic Phenotypes That Correlate with Their Clinical Classification

Metabolic reprogramming of cancer cells represents an orchestrated network of evolving molecular and functional adaptations during oncogenic progression. In particular, how metabolic reprogramming is orchestrated in breast cancer and its decisive role in the oncogenic process and tumor evolving adaptations are well consolidated at the molecular level. Nevertheless, potential correlations between functional metabolic features and breast cancer clinical classification still represent issues that have not been fully studied to date. Accordingly, we aimed to investigate whether breast cancer cell models representative of each clinical subtype might display different metabolic phenotypes that correlate with current clinical classifications. In the present work, functional metabolic profiling was performed for breast cancer cell models representative of each clinical subtype based on the combination of enzyme inhibitors for key metabolic pathways, and isotope-labeled tracing dynamic analysis. The results indicated the main metabolic phenotypes, so-called ‘metabophenotypes’, in terms of their dependency on glycolytic metabolism or their reliance on mitochondrial oxidative metabolism. The results showed that breast cancer cell subtypes display different metabophenotypes. Importantly, these metabophenotypes are clearly correlated with the current clinical classifications.

Interobserver and Intraobserver Reproducibility and Reliability of the Huashan Clinical Classification System for Hirayama Disease

Purpose: The Huashan clinical classification system for Hirayama disease has recently been proposed and has been found useful for diagnosis and treatment. So far, however, there has been little in-depth evaluation of its reliability. Thus, this study aimed to assess the reproducibility and reliability of the system.Methods: Patients diagnosed with Hirayama disease between 2019 and 2020 were recruited. Seven spine surgeons from four different institutions, including an experienced group of three and an inexperienced group of four, were trained as observers of the Huashan clinical classification system for Hirayama disease, and these surgeons classified the recruited patients using the system. Then, 2 months later, they repeated the classification on the same patients in a different order. The interobserver and intraobserver agreement between the results was analyzed using percentage agreement and weighted kappa (κ) statistics.Results: A total of 60 patients were included in the analysis. For all the observers, experienced observers, and inexperienced observers, the agreement percentages were, respectively, 78.5% (κ = 0.76), 80.0% (κ = 0.78), and 78.9% (κ = 0.77), indicating substantial interobserver reproducibility. For distinguishing typical (Types I and II) and atypical (Type III) Hirayama disease among the different groups of observers, the percentage agreement ranged from 95.6 to 98.9% (κ = 0.74–0.92), indicating substantial to nearly perfect reproducibility. For suggesting conservative treatment (Types I and III) or surgery (Type II), the percentage agreement ranged from 93.3 to 96.4% (κ = 0.81–0.90), indicating nearly perfect reproducibility. As for intraobserver agreement, the percentage agreement ranged from 68.3 to 81.7% (κ = 0.65–0.79), indicating substantial reliability.Conclusion: The Huashan clinical classification system for Hirayama disease was easy to learn and apply in a clinical environment, showing excellent reproducibility and reliability. Therefore, it would be promising to apply and promote this system for the precise and individualized future treatment of Hirayama disease.