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Challenges and Advances in Monitoring and Diagnosis in Medical Sciences

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (15 January 2021) | Viewed by 44961

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Special Issue Editors

Prof. Dr. Mihaela Badea

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Guest Editor

Faculty of Medicine, Research Centre for Fundamental Research and Prevention Strategies in Medicine, Transilvania University of Brasov, B-dul Eroilor nr 29, 500036 Brasov, Romania
Interests: bioanalytical methods; electrochemical (bio) sensors; biochemistry; antioxidants detection; telemedicine; plant food supplements
Special Issues, Collections and Topics in MDPI journals

Dr. Laura Elena Gaman

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Guest Editor

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Medicine, Bucharest, Romania
Interests: the oxidative stress associated with different diseases: mitochondrial disease in children, atherosclerosis and cardiovascular disease, neurological disease like schizophrenia, Alzheimer’s, diabetes, and renal chronic disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Monitoring and diagnosis in medical sciences require a combination of medical skills, most of the time involving multidisciplinary teams. The beginning of analysis starts with specific signs and symptoms, and the recommendation of classic and modern lab tests and/or computer-assisted diagnostics. (Tele)diagnosis and (tele)monitoring are important for modern medicine in order to have continuous information about patient status and recovery progress. Medical approaches for a personalized diagnosis and treatment of each patient are the recent and future healthcare recommendations.

This Special Issue aims to invite authors to present their challenging experiences in monitoring and diagnosis in medical sciences.

We invite the submission of original manuscripts dealing with the proposed topics, including but not limited to these presented in the frame of the International Conference NT-SMT-LS 2020 (http://www.healthfoodenviron.unitbv.ro/2020/), to be held in Bucharest, Romania. A special discount of 10% will be provided to papers presented during the conference if the article is accepted by at least two independent reviewers of the journal.

The submission deadline is 15 January 2021. You may send your manuscript at any point from now until the deadline.

We look forward to welcoming your contribution to this Special Issue.

Prof. Dr. Mihaela Badea
Assoc Prof. Dr. Laura Elena Gaman
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (12 papers)

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Research

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11 pages, 1775 KiB

Open AccessArticle

Methods for Testing the Subjective Visual Vertical during the Chronic Phase of Menière’s Disease

by Samira Ira Zabaneh, Linda Josephine Voss, Agnieszka J. Szczepek, Heidi Olze and Katharina Stölzel

Diagnostics 2021, 11(2), 249; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11020249 - 05 Feb 2021

Cited by 7 | Viewed by 2526

Abstract

The subjective visual vertical (SVV) evaluates the function of the utricle, which, in patients with Menière’s disease (MD), can be affected by endolymphatic hydrops. This study aimed to determine the SVV in MD patients during the chronic phase of illness compared to healthy participants. The second aim was to compare the SVV measurement tools: the analog bucket test, digital bucket test, and C-SVV© goggles. The SVV scores differed significantly between MD patients and the control group for the analog bucket test (p < 0.001) and the C-SVV^® goggles (p = 0.028), but no significance was shown when using the digital bucket test (p = 0.062). When comparing the analog bucket test and the C-SVV^® goggles applying the calculated threshold (1.125° in analog bucket test, 2.5° in C-SVV^® goggles), the bucket test showed higher accuracy (bucket test 73.84%, C-SVV^® goggles 69.23%). When examining the influence of betahistine on SVV scores, there were no statistically significant differences in both the analog bucket test and C-SVV© goggles. We conclude that SVV test can be used as an additional tool to evaluate utricle function during the chronic phase of MD and that the analog bucket test produces the most reliable results. The intake of betahistine does not influence the perception of SVV. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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18 pages, 2929 KiB

Open AccessArticle

Aging and Allostasis: Using Bayesian Network Analytics to Explore and Evaluate Allostatic Markers in the Context of Aging

by Victor Kallen, Muhammad Tahir, Andrew Bedard, Bart Bongers, Natal van Riel and Nico van Meeteren

Diagnostics 2021, 11(2), 157; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11020157 - 21 Jan 2021

Cited by 6 | Viewed by 3124

Abstract

Allostatic load reflects the cumulative strain on organic functions that may gradually evolve into overt disease. Our aim was to evaluate the allostatic parameters in the context of aging, and identify the parameters that may be suitable for an allostatic load index for elderly people (>60 years). From previously published studies, 11 allostatic (bio)markers could be identified that sustain sufficient variability with aging to capture meaningful changes in health status. Based on reported statistics (prevalence of a biomarker and its associated outcome, and/or an odds/risk ratio relating these two), seven of these could be adopted in a Bayesian Belief Network (BBN), providing the probability of “disturbed” allostasis in any given elder. Additional statistical analyses showed that changes in IL-6 and BMI contributed the most to a “disturbed” allostasis, indicating their prognostic potential in relation to deteriorating health in otherwise generally healthy elderly. In this way, and despite the natural decline in variance that irrevocably alters the prognostic relevance of most allostatic (bio)markers with aging, it appeared possible to outline an allostatic load index specifically for the elderly. The allostatic parameters here identified might consequently be considered a useful basis for future quantitative modelling in the context of (healthy) aging. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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14 pages, 1900 KiB

Open AccessArticle

Detecting Oropharyngeal and Esophageal Emptying by Submental Ultrasonography and High-Resolution Impedance Manometry: Intubated vs. Non-Intubated Video-Assisted Thoracoscopic Surgery

by Chih-Jun Lai, Jin-Shing Chen, Shih-I Ho, Zhi-Yin Lu, Yi-Ju Huang and Ya-Jung Cheng

Diagnostics 2020, 10(12), 1079; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10121079 - 12 Dec 2020

Viewed by 1700

Abstract

Postoperative swallowing, affected by general anesthesia and intubation, plays an important part in airway and oral intake safety regarding effective oropharyngeal and esophageal emptying. However, objective evidence is limited. This study aimed to determine the time required from emergence to effective oropharyngeal and esophageal emptying in patients undergoing non-intubated (N) or tracheal-intubated (I) video-assisted thoracoscopic surgery (VATS). Hyoid bone displacement (HBD) by submental ultrasonography and high-resolution impedance manometry (HRIM) measurements were used to assess oropharyngeal and esophageal emptying. HRIM was performed every 10 min after emergence, up to 10 times. The primary outcome was to determine whether intubation affects the time required from effective oropharyngeal to esophageal emptying. The secondary outcome was to verify if HBD is comparable to preoperative data indicating effective oropharyngeal emptying. Thirty-two patients suitable for non-intubated VATS were recruited. Our results showed that comparable HBDs were achieved in all patients after emergence. Effective esophageal emptying was achieved at the first HRIM measurement in 11 N group patients and 2 I group patients (p = 0.002) and was achieved in all N (100%) and 13 I group patients (81%) within 100 min (p = 0.23). HBD and HRIM are warranted for detecting postoperative oropharyngeal and esophageal emptying. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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18 pages, 1536 KiB

Open AccessArticle

A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

by Andrés Herane-Vives, Susana Espinoza, Rodrigo Sandoval, Lorena Ortega, Luis Alameda, Allan H. Young, Danilo Arnone, Alexander Hayes and Jan Benöhr

Diagnostics 2020, 10(12), 1069; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10121069 - 10 Dec 2020

Cited by 3 | Viewed by 7139

Abstract

Diabetes is the fourth cause of death globally. To date, there is not a practical, as well as an accurate sample for reflecting chronic glucose levels. We measured earwax glucose in 37 controls. Participants provided standard serum, glycated hemoglobin (HbA_1c) and earwax samples at two time-points, one month apart. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device, in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA_1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycemia and more efficient standardization at follow up. Earwax demonstrated to be more predictable than HbA_1c in reflecting systemic fasting, postprandial and long-term glucose levels, and to be less influenced by confounders. Earwax glucose measurements were approximately 60% more predictable than HbA_1c in reflecting glycemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycemia. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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11 pages, 8527 KiB

Open AccessArticle

Integrating Finite Element Death Technique and Bone Remodeling Theory to Predict Screw Loosening Affected by Radiation Treatment after Mandibular Reconstruction Surgery

by Le-Jung Wu, Kai-Hung Hsieh and Chun-Li Lin

Diagnostics 2020, 10(10), 844; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10100844 - 19 Oct 2020

Cited by 3 | Viewed by 2603

Abstract

This study developed a numerical simulation to understand bone mechanical behavior and micro-crack propagation around a fixation screw with severe mandibular defects. A mandible finite element (FE) model was constructed in a rabbit with a right unilateral body defect. The reconstruction implant was designed to be fixed using six screws distributed on the distal and mesial sides. The element death technique provided in FE analysis was combined with bone remodeling theory to simulate bone necrosis around the fixation screw in which the strain value reached the overload threshold. A total of 20 iterations were performed to observe the micro-crack propagation pattern for each screw according to the high strain locations occurring in each result from consecutive iterations. A parallel in vivo animal study was performed to validate the FE simulation by placing specific metal 3D printing reconstruction implants in rabbits to compare the differences in bone remodeling caused by radiation treatment after surgery. The results showed that strain values of the surrounding distal bone fixation screws were much larger than those at the mesial side. With the increase in the number of iteration analyses, the micro-crack prorogation trend for the distal fixation screws can be represented by the number and element death locations during the iteration analysis process. The corresponding micro-movement began to increase gradually and induced screw loosening after iteration calculation. The strained bone results showed that relatively high bone loss (damage) existed around the distal fixation screws under radiation treatment. This study concluded that the FE simulation developed in this study can provide a better predictive diagnosis method for understanding fixation screw loosening and advanced implant development before surgery. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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13 pages, 2637 KiB

Open AccessArticle

Inertial Sensors as a Tool for Diagnosing Discopathy Lumbosacral Pathologic Gait: A Preliminary Research

by Sebastian Glowinski, Karol Łosiński, Przemysław Kowiański, Monika Waśkow, Aleksandra Bryndal and Agnieszka Grochulska

Diagnostics 2020, 10(6), 342; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10060342 - 26 May 2020

Cited by 28 | Viewed by 3509

Abstract

Background: the goal of the study is to ascertain the influence of discopathy in the lumbosacral (L-S) segment on the gait parameters. The inertial sensors are used to determine the pathologic parameters of gait. Methods: the study involved four patients (44, 46, 42, and 38 years). First, the goal of the survey was to analyze by a noninvasive medical test magnetic resonance imaging (MRI) of each patient. Next, by using inertial sensors, the flexion-extension of joint angles of the left and right knees were calculated. The statistical analysis was performed. The wavelet transform was applied to analyze periodic information in the acceleration data. Results: in the patients with discopathy, the amount of knee flexion attained during stance phase is significantly lower than that of normal (health side), which could indicate poor eccentric control or a pain avoidance mechanism. The biggest differences are observed in the Initial Swing phase. Bending of the lower limb in the knee joint at this stage reaches maximum values during the entire gait cycle. Conclusions: It has been difficult to quantify the knee angle during gait by visual inspection. The inertial measurement unit (IMU) system can be useful in determining the level of spine damage and its degree. In patients in the first stages of the intervertebral disc disease who may undergo conservative treatment, it may also partially delay or completely exclude the decision to perform a complicated imaging examination which is MRI, often showing a false positive result in this phase of the disease. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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16 pages, 3753 KiB

Open AccessArticle

Circulating Monocyte Count as a Surrogate Marker for Ventricular-Arterial Remodeling and Incident Heart Failure with Preserved Ejection Fraction

by Kuang-Te Wang, Yen-Yu Liu, Kuo-Tzu Sung, Chuan-Chuan Liu, Cheng-Huang Su, Ta-Chuan Hung, Chung-Lieh Hung, Chen-Yen Chien and Hung-I Yeh

Diagnostics 2020, 10(5), 287; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10050287 - 08 May 2020

Cited by 7 | Viewed by 2723

Abstract

Among 2085 asymptomatic subjects (age: 51.0 ± 10.7 years, 41.3% female) with data available on common carotid artery diameter (CCAD) and circulating total white blood cell (WBC) counts, higher circulating leukocytes positively correlated with higher high sensitivity C-reactive protein (hs-CRP). Higher WBC/segmented cells and monocyte counts were independently associated with greater relative wall thicknesses and larger CCADs, which in general were more pronounced in men and obese subjects (body mass index ≥ 25 kg/m²) (all P _interaction: < 0.05). Using multivariate adjusting models, only the monocyte count independently predicted the left ventricular mass index (LVMi) (ß-Coef: 0.06, p = 0.01). Higher circulating WBC, segmented, and monocyte counts and a greater CCAD were all independently associated with a higher risk of heart failure (HF)/all-cause death during a median of 12.1 years of follow-up in fully adjusted models, with individuals manifesting both higher CCADs and monocyte counts incurring the highest risk of HF/death (adjusted hazard ratio: 2.81, 95% CI: 1.57. −5.03, p < 0.001; P _interaction, 0.035; lower CCAD/lower monocyte as reference). We conclude that a higher monocyte count is associated with cardiac remodeling and carotid artery dilation. Both an elevated monocyte count and a larger CCAD may indicate a specific phenotype that confers the highest risk of HF, which likely signifies the role of circulating monocytes in the pathophysiology of heart failure with preserved ejection fraction (HFpEF). Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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Review

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30 pages, 1351 KiB

Open AccessReview

A Review of Biophysiological and Biochemical Indicators of Stress for Connected and Preventive Healthcare

by Talha Iqbal, Adnan Elahi, Pau Redon, Patricia Vazquez, William Wijns and Atif Shahzad

Diagnostics 2021, 11(3), 556; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030556 - 19 Mar 2021

Cited by 13 | Viewed by 5380

Abstract

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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16 pages, 2911 KiB

Open AccessReview

Rare Causes of Arterial Hypertension and Thoracic Aortic Aneurysms—A Case-Based Review

by Svetlana Encica, Adrian Molnar, Simona Manole, Teodora Filan, Simona Oprița, Eugen Bursașiu, Romana Vulturar and Laura Damian

Diagnostics 2021, 11(3), 446; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030446 - 05 Mar 2021

Cited by 1 | Viewed by 2589

Abstract

Thoracic aortic aneurysms may result in dissection with fatal consequences if undetected. A young male patient with no relevant familial history, after having been investigated for hypertension, was diagnosed with an ascending aortic aneurysm involving the aortic root and the proximal tubular segment, associated with a septal atrial defect. The patient underwent a Bentall surgery protocol without complications. Clinical examination revealed dorso–lumbar scoliosis and no other signs of underlying connective tissue disease. Microscopic examination revealed strikingly severe medial degeneration of the aorta, with areas of deep disorganization of the medial musculo–elastic structural units and mucoid material deposition. Genetic testing found a variant of unknown significance the PRKG1 gene encoding the protein kinase cGMP-dependent 1, which is important in blood pressure regulation. There may be genetic links between high blood pressure and thoracic aortic aneurysm determinants. Hypertension was found in FBN1 gene mutations encoding fibrillin and in PRKG1 mutations. Possible mechanisms involving the renin–angiotensin system, the role of oxidative stress, osteopontin, epigenetic modifications and other genes are reviewed. Close follow-up and strict hypertension control are required to reduce the risk of dissection. Hypertension, scoliosis and other extra-aortic signs suggesting a connective tissue disease are possible clues for diagnosis. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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14 pages, 776 KiB

Open AccessReview

Accelerometric Assessment of Postural Balance in Children: A Systematic Review

by Jose L. García-Soidán, Raquel Leirós-Rodríguez, Vicente Romo-Pérez and Jesús García-Liñeira

Diagnostics 2021, 11(1), 8; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11010008 - 22 Dec 2020

Cited by 15 | Viewed by 3402

Abstract

The correct development of postural control in children is fundamental to ensure that they fully reach their psychomotor capacities. However, this capacity is one of the least studied in the clinical and academic scope regarding children. The objective of this study was to analyze the degree of implementation of accelerometry as an evaluation technique for postural control in children and how it is being used. Methods: A systematic search was conducted in PubMed, SpringerLink, SportsDiscus, Medline, Scopus, and Web of Science with the following terms: balance, postural control, children, kids, accelerometry, and accelerometer. Results: The search generated a total of 18 articles. Two groups of studies were differentiated: those which exclusively included healthy individuals (n = 5) and those which included children with pathologies (n = 13). Accelerometry is being used in children mainly to assess the gait and static balance, as well as to identify the differences between healthy children and children with developmental disorders. Conclusions: Accelerometry has a discrete degree of implementation as an evaluation tool to assess postural control. It is necessary to define a systematic method for the evaluation of postural control in pediatrics, in order to delve into the development of this capacity and its alterations in different neurodevelopmental disorders. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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11 pages, 1326 KiB

Open AccessReview

Efficacy and Safety of Digital Single-Operator Cholangioscopy in the Diagnosis of Indeterminate Biliary Strictures by Targeted Biopsies: A Systematic Review and Meta-Analysis

by Li-Jia Wen, Jun-Hong Chen, Hong-Ji Xu, Qiong Yu and Kai Liu

Diagnostics 2020, 10(9), 666; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10090666 - 02 Sep 2020

Cited by 27 | Viewed by 2820

Abstract

Background: Biliary strictures are frequently encountered in clinical practice. The determination of their nature is often difficult. This study aims to systematically evaluate the efficacy and safety of the second generation of digital single-operator cholangioscopy (SpyGlass DS, DSOC) in indeterminate biliary strictures (IBDS) through biopsies. Methods: All relative studies published in Medline, the Cochrane Library, Web of Science, and EMBASE were included. The diagnostic tests for IBDS were compared to the surgical histology, autopsy, or long-term clinical follow-up. The methodological quality of the included studies was evaluated by the Quality Assessment of Studies of Diagnostic Accuracy Included in Systematic Reviews (QUADAS-2). Results: A total of 11 studies, which involved 356 patients diagnosed through biopsies, were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.74 (95% CI: 0.67–0.80), 0.98 (95% CI: 0.95–1.00), 10.52 (95% CI: 5.45–20.32), 0.31 (95% CI: 0.23–0.41), and 65.18 (95% CI: 26.79–158.61), respectively. The area under the curve (AUC) was 0.9479, and the pooled adverse event rate was 7%. The sensitivity and specificity in the heterogeneity analysis were I² = 48.1% and I² = 25.4%, respectively. Conclusion: SpyGlass DS is a safe and effective technique for IBDS. However, future randomized trials are needed to determine optimal number of biopsies. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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Other

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6 pages, 1979 KiB

Open AccessCase Report

“Noninfective Endocarditis”: A Case Report of Hereditary Coagulation Disorders in a 28-Year-Old Male

by Gregory Reid, Luca Koechlin, Oliver Reuthebuch, Florian Rüter, Helmut Hopfer, Friedrich Eckstein and David Santer

Diagnostics 2020, 10(6), 384; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10060384 - 08 Jun 2020

Cited by 3 | Viewed by 5830

Abstract

We report a case of a young male who presented with acute limb ischemia after sport. With no prior history of disease, a non-infective endocarditis of the native aortic valve was diagnosed. After surgical valve replacement, the patient suffered from acute myocardial ischemia under phenprocoumon therapy. Anti-coagulant monitoring was subsequently changed to Factor II analysis after a rare Factor VII deficiency and prothrombin mutation (G20210A) was diagnosed. Full article

(This article belongs to the Special Issue Challenges and Advances in Monitoring and Diagnosis in Medical Sciences)

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