Invasive hemodynamic assessment of patients with cardiomyopathies

Invasive hemodynamic assessment of cardiac diseases has become an important diagnostic tool in recent decades. Non-invasive methods are the main techniques used to assess cardiac function, due to their wider availability. Cardiac catheterization is useful when there are diagnostic problems that cannot be solved with routine methods. Cardiac catheterization should be individualized according to the specific problems of the patient and based on the results from non-invasive methods. Invasive diagnostics is used in the assessment of patients with various cardiovascular diseases, including cardiomyopathies. In this review, we consider the role of cardiac catheterization, its advantages and disadvantages as part of the overall assessment of patients with cardiomyopathies.  

The salivary metatranscriptome as an accurate diagnostic indicator of oral cancer

Despite advances in cancer treatment, the 5-year mortality rate for oral cancers (OC) is 40%, mainly due to the lack of early diagnostics. To advance early diagnostics for high-risk and average-risk populations, we developed and evaluated machine-learning (ML) classifiers using metatranscriptomic data from saliva samples (n = 433) collected from oral premalignant disorders (OPMD), OC patients (n = 71) and normal controls (n = 171). Our diagnostic classifiers yielded a receiver operating characteristics (ROC) area under the curve (AUC) up to 0.9, sensitivity up to 83% (92.3% for stage 1 cancer) and specificity up to 97.9%. Our metatranscriptomic signature incorporates both taxonomic and functional microbiome features, and reveals a number of taxa and functional pathways associated with OC. We demonstrate the potential clinical utility of an AI/ML model for diagnosing OC early, opening a new era of non-invasive diagnostics, enabling early intervention and improved patient outcomes.

Malignancies and Biosensors: A Focus on Oral Cancer Detection through Salivary Biomarkers

Oral cancer is among the deadliest types of malignancy due to the late stage at which it is usually diagnosed, leaving the patient with an average five-year survival rate of less than 50%. The booming field of biosensing and point of care diagnostics can, in this regard, play a major role in the early detection of oral cancer. Saliva is gaining interest as an alternative biofluid for non-invasive diagnostics, and many salivary biomarkers of oral cancer have been proposed. While these findings are promising for the application of salivaomics tools in routine practice, studies on larger cohorts are still needed for clinical validation. This review aims to summarize the most recent development in the field of biosensing related to the detection of salivary biomarkers commonly associated with oral cancer. An introduction to oral cancer diagnosis, prognosis and treatment is given to define the clinical problem clearly, then saliva as an alternative biofluid is presented, along with its advantages, disadvantages, and collection procedures. Finally, a brief paragraph on the most promising salivary biomarkers introduces the sensing technologies commonly exploited to detect oral cancer markers in saliva. Hence this review provides a comprehensive overview of both the clinical and technological advantages and challenges associated with oral cancer detection through salivary biomarkers.

A Unified Transcriptional, Pharmacogenomic, and Gene Dependency Approach to Decipher the Biology, Diagnostic Markers, and Therapeutic Targets Associated with Prostate Cancer Metastasis

This manuscript demonstrates how integrated bioinformatic and statistical reanalysis of publicly available genomic datasets can be utilized to identify molecular pathways and biomarkers that may be clinically relevant to metastatic prostate cancer (mPrCa) progression. The most notable observation is that the transition from primary prostate cancer to mPrCa is characterized by upregulation of processes associated with DNA replication, metastasis, and events regulated by the serine/threonine kinase PLK1. Moreover, our analysis also identified over-expressed genes that may be exploited for potential targeted therapeutics and minimally invasive diagnostics and monitoring of mPrCa. The primary data analyzed were two transcriptional datasets for tissues derived from normal prostate, primary prostate cancer, and mPrCa. Also incorporated in the analysis were the transcriptional, gene dependency, and drug response data for hundreds of cell lines, including those derived from prostate cancer tissues.

Establishment of Optimal Housekeeping Genes for Urinary Extracellular Vesicle Biomarker Development: A Step Towards Non-Invasive Diagnostics

Background. Urinary extracellular vesicles (UEVs) hold RNAs and can find their application in multiplex biomarker development. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is the most commonly used method for gene expression studies. However, there are no reported optimal housekeeping genes available to normalize qPCR data for the UEVs RNA pool.Methods. UEVs were precipitated by Polyethylene glycol (P.E.G. Mn6000) from the urine of 40 human individuals and characterized for their molecular, biophysical, and biochemical purity and integrity. In addition, the expression of five commonly used housekeeping genes B2M, RPL13A, PPIA, HMBS, and GAPDH, were quantified by qPCR in the UEV RNA pool and analyzed through algorithms of NormFinder, geNorm, BestKeeper, and Delta Ct integrated into ReFinder.Results: 12% PEG precipitation yielded round and cup-shaped UEVs. The size and distribution profile of UEVs were around 30 – 100nm through electron microscopy, NTA, and DLS. Acetylcholine esterase and Dipeptidyl peptidase-IV activity were used to arrive at their functional purity. B2M and RPL13A genes were identified as stable genes with a mean stability score of 1.5(geNorm) and below 1 (NormFinder) through ReFinder, which yield comprehensive ranking analysisConclusions: B2M and RPL13A are optimal reference genes and can be used for UEVs based gene expression studies.

Een geriatrische patiënte met een perirectaal abces, pyleflebitis en multipele pyogene leverabcessen: een gevalsbespreking

A geriatric patient with a perirectal abscess, pylephlebitis and multiple pyogenic liver abscesses: a case-report. In this case study, an 86-year-old patient is presented with fever, anorexia and drowsiness, a very high C-reactive protein (CRP) level and elevated liver enzymes. Given the frailty of the patient, a non-invasive diagnostic approach was chosen. Initially, a pancreatic carcinoma with liver metastases was suspected, but the presence of positive blood cultures raised doubts about the initially suggested diagnosis. Ultimately, a perirectal abscess with Streptococcus intermedius bacteremia, pylephlebitis and multiple liver and pancreatic abscesses were diagnosed. After a course of 9 weeks of antibiotics, the patient's condition improved. The vague complaints in this geriatric patient and the lack of invasive diagnostics pose a challenge for the clinician in recognizing this disease.

Non-Invasive Diagnostics in Acute Compartment Syndrome

Diagnosis of acute compartment syndrome (ACS) of the extremities is based on clinical signs with or without complementary measurement of muscle compartmental pressure. However, in cases of imminent compartment syndrome, unconscious patients or children the appropriate diagnose remains challenging. Despite all efforts to improve technical devices to objectify the signs by measurements of numerous parameters, needle compartment pressure measurement is to date accepted as the gold standard to facilitate decision making. But its invasiveness, the controversy about pressure thresholds and its potentially limited validity due to a single measurement support the need for further developments to diagnose ACS. Numerous technical improvements have been published and revealed promising new applications for non-invasive diagnostics. Since the pathology of an ACS is well characterized two approaches of measurements are described: to detect either increasing compartmental pressure or decreasing perfusion pressure. In the following, currently known investigations are reviewed and related to their pathophysiological principals, modes of clinical application, value and reliability.

AL-amyloidosis with cardiac involvement. Diagnostic capabilities of non-invasive methods

There are presented the literature data and a description of the clinical course of the disease in isolated/predominant cardiac amyloidosis. Amyloid cardiomyopathy is the most common phenocopy of hypertrophic cardiomyopathy. The modern possibilities of non-invasive diagnostics using osteoscintigraphy for the differential diagnosis between amyloid cardiomyopathy caused by AL- and transthyretin amyloidosis are described in detail.