Clinical characteristics and prognosis of serous body cavity effusions in patients with sepsis: a retrospective observational study

Clone Selection Artificial Intelligence Algorithm-Based Positron Emission Tomography-Computed Tomography Image Information Data Analysis for the Qualitative Diagnosis of Serous Cavity Effusion in Patients with Malignant Tumors

This study aimed to investigate the application of positron emission tomography- (PET-) computed tomography (CT) image information data combined with serous cavity effusion based on clone selection artificial intelligence algorithm in the diagnosis of patients with malignant tumors. A total of 97 patients with PET-CT scanning and empirically confirmed as serous cavity effusion were retrospectively analyzed in this study. The clone selection artificial intelligence algorithm was applied to register the PET-CT images, and the patients were rolled into a benign effusion group and a malignant effusion group according to the benign and malignant conditions of the serous cavity effusion. Besides, the causes of patients from the two groups were analyzed, and there was a comparison of their physiological conditions. Subsequently, CT values of different KeV, lipid/water, water/iodine, and water/calcium concentrations were measured, and the differences of the above quantitative parameters between benign and malignant serous cavity effusion were compared, as well as the registration results of the clone algorithm. The results showed that the registration time and misalignment times of clonal selection algorithm (13.88, 0) were lower than those of genetic algorithm (18.72, 8). There were marked differences in CT values of 40-60 keV and 130-140 keV between the two groups. The concentrations of lipid/water, water/iodine, and water/calcium in basal substances of the malignant effusion group were obviously higher than the concentrations of the benign effusion group (P < 0.05). Benign and malignant effusions presented different manifestations in PET-CT, which was conducive to the further diagnosis of malignant tumors. Based on clone selection artificial intelligence algorithm, PET-CT could provide a new multiparameter method for the identification of benign and malignant serous cavity effusions and benign and malignant tumors.

How a discerning cytological examination can aid in the diagnosis of infectious diseases: case reports

Infections caused by uncommon and resistant pathogens in unusual sites have been increasingly reported in medical literature. We describe four cases of rare cytological findings and clinical impact for patients. In the first case, Aspergillus sp and Pneumocystis jirovecii were observed in the bronchoalveolar lavage of a patient with severe systemic lupus. In the second and third cases, we describe the presence of Trichomonas sp and Strongyloides sp larvae in samples of pleural and peritoneal fluid, respectively. The fourth report is about a patient with a wrist subcutaneous nodule whose synovial aspiration and cytology revealed the presence of brown septate hyphae. The early identification of the infectious agent in the cytological examination was essential for the introduction and/or re-adaptation of therapy in the four cases described. Patients in this report were immunocompromised with severe comorbidities, conditions often associated with unfavorable clinical outcomes.

Plasma PTX3, MCP1 and Ang2 are early biomarkers to evaluate the severity of sepsis and septic shock

Sepsis is associated with significant mortality. Early diagnosis and prognosis of patients with sepsis is still a difficult clinical challenge. In this study, the ability of plasma PTX3 (pentraxin 3), MCP1 (monocyte chemoattractant protein 1) and Ang (angiopoietin)1/2 was investigated to evaluate the severity of sepsis. Blood samples were obtained from 43 patients with sepsis. A total of 33 post‐surgery patients with infections and 25 healthy individuals served as controls. The results showed that plasma PTX3, MCP1 and Ang2 significantly increased in patients on the first day of septic shock onset, while sepsis patients had significantly higher Ang2 level, compared with controls. Furthermore, PTX3, MCP1 and Ang2 had high AUROC values in patients with septic shock on the first day of sepsis onset. The findings suggest that PTX3, MCP1 and Ang2 maybe early predictors to evaluate the severity of sepsis and septic shock with the latest Sepsis 3.0 definitions.

Accuracy of intercellular adhesion molecule-1 for diagnosing sepsis: A systematic review and meta-analysis protocol

BACKGROUND

Sepsis is a complex and life-threatening systemic disease. A positive blood culture is the criterion standard of diagnosis for sepsis; however, it does not produce results for 24 to 72 hours. Besides, the clinical manifestations of sepsis are variable and nonspecific. Therefore, a new diagnostic biomarker for diagnosis of sepsis should be developed. The present study aims to assess the diagnostic value of intercellular adhesion molecule-1 (ICAM-1) in individuals with sepsis.

METHODS

The literature will be searched in PubMed, EMBASE, the Cochrane Library, and Web of Science databases from the inception of each database up to June 2019. The methodological quality of eligible study will be assessed by Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2). Stata 15.1 software (version 15.1, Stata Corporation) will be used to calculate the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio, pre-test probability, post-test probability, and summary receiver-operating characteristic curve for diagnostic value of ICAM-1. The I statistic will be used to test heterogeneity. Subgroup analysis will be used to explore the source of inconsistency. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system will be used to assess the certainty of evidence. This study will be conducted fully following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of diagnostic test accuracy.

RESULTS AND CONCLUSIONS

Our study will detect the potential of ICAM-1 for diagnosing the patients with sepsis and the results will be submitted to a peer-reviewed journal.

DISCUSSION

The evidence will indicate that ICAM-1 is a valuable biomarker for detecting sepsis. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.