BACKGROUND: Optimal management of outpatients with heart failure (HF) requires serially updating the estimates of their risk for adverse clinical outcomes to guide treatment. Patient-reported outcomes (PROs) are becoming increasingly used in clinical care. The purpose of this study was to determine whether the inclusion of PROs can improve the risk prediction for HF hospitalization and death in ambulatory patients with HF. METHODS AND RESULTS: We included consecutive patients with HF with reduced ejection fraction (HFrEF) and HF with preserved EF (HFpEF) seen in a HF clinic between 2015 and 2019 who completed PROs as part of routine care. Cox regression with a least absolute shrinkage and selection operator regularization and gradient boosting machine analyses were used to estimate risk for a combined outcome of HF hospitalization, heart transplant, left ventricular assist device implantation, or death. The performance of the prediction models was evaluated with the time-dependent concordance index (Cτ). Among 1165 patients with HFrEF (mean age 59.1 ± 16.1, 68% male), the median follow-up was 487 days. Among 456 patients with HFpEF (mean age 64.2 ± 16.0 years, 55% male) the median follow-up was 494 days. Gradient boosting regression that included PROs had the best prediction performance - Cτ 0.73 for patients with HFrEF and 0.74 in patients with HFpEF, and showed very good stratification of risk by time to event analysis by quintile of risk. The Kansas City Cardiomyopathy Questionnaire overall summary score, visual analogue scale and Patient Reported Outcomes Measurement Information System dimensions of satisfaction with social roles and physical function had high variable importance measure in the models. CONCLUSIONS: PROs improve risk prediction in both HFrEF and HFpEF, independent of traditional clinical factors. Routine assessment of PROs and leveraging the comprehensive data in the electronic health record in routine clinical care could help more accurately assess risk and support the intensification of treatment in patients with HF.

• MeSH
• Risk Assessment methods   MeSH
• Patient Reported Outcome Measures * MeSH
• Hospitalization statistics & numerical data   MeSH
• Quality of Life * psychology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Heart Failure * physiopathology   psychology   therapy   diagnosis   mortality   MeSH
• Stroke Volume physiology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Cíl: V počtech mechanické trombektomie (MT) symptomatického uzávěru velké mozkové tepny u pacientů s akutní ischemickou cévní moz- kovou příhodou (iCMP) na počet obyvatel se řadí Česká republika na přední místa v Evropě. Cílem práce bylo na základě analýzy dat studie METRICS II (Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centers II) zhodnotit aktuální výsledky léčby iCMP a vývoj plnění indikátorů kvality napříč republikou. Sekundárním cílem práce byla subanalýza souboru z hlediska použité techniky MT a jejího vlivu na úspěšnost rekanalizace uzávěru velké mozkové tepny. Metodika: Národní prospektivní observační studie METRICS II probíhala v České republice od 1. ledna 2023 do 31. prosince 2023. Studie se zúčastnilo jedenáct z patnácti center provádějících MT. Všechna technická a klinická data byla sbírána prospektivně. Výsledky léčby iCMP byly následně srovnány s doporučenými hodnotami jednotlivých parametrů multioborového konsenzu a výsledky studie METRICS probíhající v roce 2019. Data vztahující se k vlastní technice MT v předním povodí byla podrobena subanalýze a statisticky zpracována z hlediska vlivu použité techniky na úspěšnost rekanalizace uzávěru velké mozkové tepny. Výsledky: V práci jsou analyzována data z jedenácti center, ve kterých byla mechanická trombektomie provedena celkem 1312 pacientům (51,1 % mužů) průměrného věku 70,9 roků (SD ± 12,7). Intravenózní trombolýzou (IVT) byli před MT léčeni 894 nemocní (68,2 %) a 426 (32,5 %) bylo sekundárně transportováno k MT z jiného centra. Získaná data z národní prospektivní observační studie METRICS II byla hodnocena jako celek i pro jednotlivá centra. Shoda výsledků péče s doporučeními navrženými multioborovým konsenzem byla velmi vysoká. Sedm center splnilo parametry všech doporučení. Ostatní centra nesplnila pouze ojedinělá kritéria a ve většině případů jen hraničně. Statistickým zpracováním souboru MT v přední cirkulaci byla prokázána signifikantní závislost mezi typem MT a dosažením rekanalizace (TICI 2b–3, p = 0,0004, resp. TICI 2c/3, p < 0,0001). Závěr: Výsledky studie METRICS II ukázaly vysokou kvalitu péče o pacienty s uzávěrem velké mozkové tepny léčených MT. Statistickým zpracováním souboru MT v přední cirkulaci byla prokázána signifikantní závislost mezi typem MT a dosažením rekanalizace. Pro skupinu pacientů, u kterých proběhla MT kombinací aspirace a rekanalizace za pomoci stentretrieveru sekundárně, byla nalezena signifikantně nižší úspěšnost rekanalizace uzávěru velké mozkové tepny.

Aim: The Czech Republic is among the leading countries in Europe in the number of mechanical thrombectomy (MT) procedures for symptomatic large vessel occlusion (LVO) in patients with acute ischemic stroke per population. The aim of this study was to evaluate the current outcomes of acute ischemic stroke treatment and the development of treatment quality indicators in the Czech Republic based on the analysis of data from the METRICS II study (Mechanical Thrombectomy Quality Indicators Study in Czech Stroke Centres II). The secondary aim of the study was to subanalyze the cohort in terms of the MT technique used and its impact on the success of recanalisation of the LVO. Methods: The national prospective observational study METRICS II was conducted in the Czech Republic from 1 January 2023 to 31 December 2023. Eleven of the 15 centres performing MT participated in the study. All technical and clinical data were collected prospectively. The results of ischemic stroke treatment were then compared with the recommended values of the individual parameters of the multidisciplinary consensus and the results of the METRICS study ongoing in 2019. Data related to the actual technique of MT in the anterior circulation were subanalyzed and statistically processed for the effect of the technique used on the success of recanalization of the LVO. Results: Data from 11 centres in which mechanical thrombectomy was performed on a total of 1312 patients (51.1% male) with a mean age of 70.9 years (SD ± 12.7) were analysed. IV thrombolysis prior MT was performed in 894 (68.2%) patients and 426 (32.5%) patients were transferred secondarily for MT from primary stroke centers to dedicated comprehensive centers. Data obtained from the national prospective observational METRICS II study were evaluated as a whole and for individual centers. The concordance of results with the recommendations of multi- society consensus was very high. Seven centers met the parameters of all recommendations. The remaining centers failed to meet only isolated criteria and only marginally. Statistical analysis of the anterior circulation MT cohort showed a significant relationship between MT type and achievement of recanalization (TICI 2b-3, p = 0.0004 and TICI 2c/3, p < 0.0001, respectively). Conclusion: The results of METRICS II showed a high quality of care for patients with large cerebral artery occlusion treated with MT. Statistical analysis of a cohort of anterior circulation MTs showed a significant relation- ship between the type of MT and the achievement of recanalisation. A significantly lower success rate of recanalization of LVO was found for the group of patients who underwent MT by a combination of aspiration and recanalization using a stent retriever secondarily.

With the incorporation of effective therapies for myelofibrosis (MF), accurately predicting outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) is crucial for determining the optimal timing for this procedure. Using data from 5183 patients with MF who underwent first allo-HCT between 2005 and 2020 at European Society for Blood and Marrow Transplantation centers, we examined different machine learning (ML) models to predict overall survival after transplant. The cohort was divided into a training set (75%) and a test set (25%) for model validation. A random survival forests (RSF) model was developed based on 10 variables: patient age, comorbidity index, performance status, blood blasts, hemoglobin, leukocytes, platelets, donor type, conditioning intensity, and graft-versus-host disease prophylaxis. Its performance was compared with a 4-level Cox regression-based score and other ML-based models derived from the same data set, and with the Center for International Blood and Marrow Transplant Research score. The RSF outperformed all comparators, achieving better concordance indices across both primary and postessential thrombocythemia/polycythemia vera MF subgroups. The robustness and generalizability of the RSF model was confirmed by Akaike information criterion and time-dependent receiver operating characteristic area under the curve metrics in both sets. Although all models were prognostic for nonrelapse mortality, the RSF provided better curve separation, effectively identifying a high-risk group comprising 25% of patients. In conclusion, ML enhances risk stratification in patients with MF undergoing allo-HCT, paving the way for personalized medicine. A web application (https://gemfin.click/ebmt) based on the RSF model offers a practical tool to identify patients at high risk for poor transplantation outcomes, supporting informed treatment decisions and advancing individualized care.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Survival Rate MeSH
• Primary Myelofibrosis * therapy   mortality   MeSH
• Prognosis MeSH
• Aged MeSH
• Machine Learning * MeSH
• Hematopoietic Stem Cell Transplantation * mortality   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Thyroid hormones (TH) are essential for vertebrate development, growth, and metabolism. The increasing prevalence of anthropogenic chemicals with TH-disrupting potential highlights the urgent need for advanced methods to assess their impact on TH homeostasis. Inhibition of the sodium-iodide symporter (NIS) has been identified as a key molecular initiating event disrupting the TH system across species, with significant relevance for diagnostic and therapeutic applications in various carcinomas. This study presents in vitro bioassays for evaluating the effects of compounds on iodide uptake into cells, a critical step in TH production mediated by NIS. Two novel stably transfected human cell lines overexpressing human NIS were employed along with a rat thyroid cell model FRTL-5, using colorimetric Sandell-Kolthoff (SK) reaction for iodide detection. The results from 23 model compounds demonstrate comparability across various in vitro models and radioactivity-based assays. To enhance physiological relevance, an external biotransformation system (BTS) was integrated and optimized for live-cell compatibility without inducing cytotoxicity or interfering with the assay. Compounds identified as NIS inhibitors were evaluated using the BTS-augmented assay, which revealed that metabolic activity mitigated the inhibitory effects of some chemicals. The augmented assay exhibited strong concordance with in vivo and in silico biotransformation data. Protein sequence alignment confirmed high conservation of NIS functional domains across vertebrates, reinforcing the cross-species applicability of the findings. The SK-based NIS assay, with optional BTS integration, represents a sensitive, robust, and high-throughput amendable alternative to radioactivity-based methods, for characterizing the impacts of individual compounds and complex environmental mixtures on TH homeostasis.

• MeSH
• Biological Assay methods   MeSH
• Biotransformation MeSH
• Cell Line MeSH
• Endocrine Disruptors * toxicity   MeSH
• Thyroid Hormones metabolism   MeSH
• Iodides * metabolism   MeSH
• Rats MeSH
• Humans MeSH
• Thyroid Gland metabolism   drug effects   cytology   MeSH
• Symporters * antagonists & inhibitors   metabolism   genetics   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

AIMS: The 2020 European Society of Cardiology (ESC)-atrial fibrillation (AF) guidelines recommend a risk-based approach to oral anticoagulation (OAC) therapy in patients with AF; however, it is unknown if current practice aligns with these recommendations. This study assessed the associated effectiveness and safety of edoxaban in patients with AF according to the 2020 ESC-AF guidelines and the approved label in routine clinical care. METHODS AND RESULTS: The Global ETNA-AF programme is a large prospective, noninterventional programme evaluating safety and effectiveness of edoxaban. Baseline characteristics and 2-year clinical event data were analysed in subgroups, defined by ESC-AF guidelines indication of OAC therapy according to CHA2DS2-VASc score [no OAC to be considered, OAC should be considered (2 for females/1 for males), and OAC recommended (≥3 for females/≥2 for males)] and modified HAS-BLED score [(≥3 (bleeding risk high) vs. <3 (bleeding risk low)]. Of 19 960 patients included, 16 912 (84.7%) were categorized as OAC recommended and 2501 (12.5%) as OAC should be considered; 547 (2.7%) were in the no OAC to be considered group. In the OAC recommended group, 12 006 (71.0%) had high bleeding risk. Clinical event rates were <5%/year across all risk groups, even in the OAC recommended and high bleeding risk groups. In the OAC recommended and high bleeding risk groups, patients had low ischaemic stroke and bleeding event rates, regardless of receiving the 30 or 60 mg dose. CONCLUSION: This study demonstrated that edoxaban use in patients with AF largely aligns with 2020 ESC-AF guidelines, while maintaining low clinical event rates. REGISTRATION: Europe (NCT02944019), Japan (UMIN000017011), and Korea/Taiwan (NCT02951039).

• Publication type
• Journal Article MeSH

OBJECTIVES: SENTIX was a prospective, single-arm, international multicenter study that evaluated sentinel lymph node biopsy without pelvic lymph node dissection in patients with early-stage cervical cancer. We aimed to evaluate the concordance between preoperative imaging modalities (magnetic resonance imaging (MRI) and ultrasound) and final pathology in the clinical staging of early-stage cervical cancer by post-hoc analysis of the SENTIX study data. METHODS: In total, 47 sites across 18 countries participated in the SENTIX study. Patients with Stage IA1/lymphovascular space invasion-positive to IB2 (International Federation of Gynecology and Obstetrics (FIGO) classification (2018)) cervical cancer, with usual histological types and no suspicious lymph nodes on imaging, were prospectively enrolled between May 2016 and October 2020. Preoperative pelvic clinical staging on either pelvic MRI or ultrasound examination was mandatory. Tumor size discrepancy (< 10 mm vs ≥ 10 mm) between imaging and pathology, as well as the negative predictive value (NPV) of MRI and ultrasound for parametrial involvement and lymph node macrometastasis, were analyzed. RESULTS: Among 690 eligible prospectively enrolled patients, MRI and ultrasound were used as the staging imaging modality in 322 (46.7%) and 298 (43.2%) patients, respectively. A discrepancy of tumor size ≥ 10 mm was reported between ultrasound and final pathology in 39/298 (13.1%) patients and between MRI and pathology in 53/322 (16.5%), with no significant difference in the accuracy of tumor measurement between the two imaging modalities. The NPV of ultrasound in assessing parametrial infiltration and lymph node involvement was 97.0% (95% CI, 0.95-0.99%) and 94.0% (95% CI, 0.91-0.97%), respectively, and that of MRI was 95.3% (95% CI, 0.93-0.98%) and 94.1% (95% CI, 0.92-0.97%), respectively, with no significant differences between the parameters. Ultrasound and MRI were comparable regarding the tumor size measurement (P = 0.452), failure to detect parametrial involvement (P = 0.624) and failure to detect macrometastases in sentinel lymph node (P = 0.876). CONCLUSIONS: Pelvic ultrasound examination and MRI had similar concordance with histology in the assessment of tumor size and of parametrial and lymph node invasion in early-stage cervical cancer. Ultrasound examination should be considered part of preoperative pelvic clinical staging in early-stage cervical cancer, especially in limited-resource regions where MRI is unavailable. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

• MeSH
• Sentinel Lymph Node Biopsy MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Lymphatic Metastasis diagnostic imaging   MeSH
• Lymph Nodes pathology   diagnostic imaging   MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Uterine Cervical Neoplasms * pathology   diagnostic imaging   MeSH
• Pelvis diagnostic imaging   pathology   MeSH
• Predictive Value of Tests MeSH
• Preoperative Care methods   MeSH
• Prospective Studies MeSH
• Aged MeSH
• Neoplasm Staging methods   MeSH
• Ultrasonography methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Úvod: Dosud stále platí, že pozdní záchyt onemocnění karcinomem vaječníku je zásadní příčina jeho špatné prognózy. Zatím nebyl identifikován žádný dostatečně senzitivní a zároveň specifický marker ani kombinace markerů a zobrazovacích metod, které by jednoznačně umožňovaly záchyt časných, potenciálně dobře kurabilních stadií a dále prebiopticky diferencovaly skupinu ultrazvukově špatně odlišitelných benigní lézí od maligních tumorů. V designu retrospektivní studie byly zkoumány hladiny sérového vaskulárního endoteliálního faktoru D (VEGF-D). VEGF-D má vztah k nádorem indukované angiogenezi, lymfangiogenezi a remodelaci cév s efektem facilitace metastazování a zlepšené distribuce kyslíku a živin pro nádorovou tkáň. Na druhou stranu lymfatická síť slouží jako bariéra proti nádorové diseminaci a je to transportní systém pro imunitně činné elementy v potlačování nádorového bujení. Cílem studie bylo prověřit, zda existuje rozdíl v hladinách sérového VEGF-D ve skupině pacientek s maligními tumory, s benigními lézemi vaječníku a u zdravých kontrol bez patologického nálezu na adnexech. Metody: Retrospektivně bylo zhodnoceno 162 sér odebraných předoperačně a uchovaných procesem mrazení v biobance v letech 2022–2023. Testovaný soubor byl stratifikován na základě histopatologického výsledku vyšetření adnex na skupinu maligních tumorů (n = 54), skupinu benigních lézí (n = 47) a skupinu zdravých kontrol (n = 61). Ke statistickému vyhodnocení parametrů byly použity metody deskriptivní statistické analýzy. Pro porovnání sérových hladin VEGF-D byly použity neparametrické testy. Všechny analýzy byly uvažovány na hladině významnosti 5 %. Sérový VEGF-D byl analyzován metodou ELISA Quantikine® Human VEGF D R&D Systems a hodnoty byly odečteny spektrofotometricky na readeru TECAN. Výsledky: Výsledek srovnání deskriptivních statistických parametrů je ve vyšetřovaném souboru statisticky významný (p = 0,00067) pro rozdíl mezi hodnotami sérového VEGF-D v souboru benigních lézí a maligních tumorů. Dále existuje statisticky významný rozdíl mezi hodnotami pacientek s maligními tumory a mezi zdravými kontrolami (p = 0,0008). Mezi hodnotami u pacientek s benigními lézemi a u zdravých kontrol nebyl nalezen statisticky významný rozdíl (p = 0,4308). Ve srovnání s konvenčním markerem CA125 korelovala patologicky zvýšená hladina sérového CA125 s nízkou hodnotou sérového VEGF-D u pacientek s maligními tumory. Stejná shoda panovala ve srovnání s markerem HE4: vysoké sérové hladiny HE4 byly ve skupině pacientek s maligním tumorem doprovázeny nízkou hladinou VEGF-D, navíc v bodovém grafickém zobrazení se jasně stratifikovala skupina pacientek s maligními tumory od skupiny benigních lézí a zdravých kontrol. Závěr: S ohledem na získané výsledky má vyšetřování sérové hladiny VEGF-D potenciál diagnostického testu s přínosem ke stratifikaci obtížně prebiopticky diferencovatelných adnextumorů.

Introduction: Until now, it is still true that late detection of ovarian cancer is a major cause of its poor prognosis. So far, no sufficiently sensitive and specific marker or combination of markers and imaging methods has been identified that would unambiguously allow the detection of early potentially highly-curable stages and furthermore prebioptically differentiate a group of poorly distinguishable benign lesions from malignant tumours on ultrasound. In a retrospective study design, serum levels of vascular endothelial growth factor D (VEGF-D) were investigated. VEGF-D is related to tumour-induced angiogenesis, lymphangiogenesis, and vascular remodelling with the effect of facilitating metastasis and improved oxygen and nutrient distribution into tumour tissue. On the other hand, the lymphatic network serves as a barrier against tumour dissemination and is a transport system for immune-active elements in suppressing tumorigenesis. The aim of this study was to investigate that there is a difference in serum VEGF-D levels in a group of patients with malignant tumours, benign ovarian lesions, and healthy controls without pathological findings in the adnexa. Methods: 162 sera collected preoperatively and preserved by a freezing process in a biobank in 2022–2023 were retrospectively evaluated. The test set was stratified on the basis of histopathological results of the adnexal examination into the malignant tumour group (N = 54), benign lesion group (N = 47), and healthy control group (N = 61). Descriptive statistical analysis methods were used for the statistical evaluation of the parameters. Nonparametric tests were used to compare serum VEGF-D levels. All analyses were considered at a significance level of 5%. Serum VEGF-D was analysed by ELISA Quantikine® Human VEGF D R&D Systems and values were read spectrophotometrically on a TECAN reader. Results: The result of the comparison of descriptive statistical parameters was statistically significant (P = 0.00067) for the difference between serum VEGF-D levels in the set of benign lesions and malignant tumours. Furthermore, there was a statistically significant difference between the values of patients with malignant tumours and healthy controls (P = 0.0008). No statistically significant difference was found between the values of patients with benign lesions and healthy controls (P = 0.4308). Compared to the conventional marker CA125, pathologically elevated serum CA125 levels correlated with low serum VEGF-D levels in patients with malignant tumours. The same concordance was observed in comparison with the HE4 marker: high serum HE4 levels were accompanied by low VEGF-D levels in the group of patients with malignant tumours; moreover, the dot plot clearly stratified the group of patients with malignant tumours from the group of benign lesions and healthy controls. Conclusion: In view of the results obtained, the investigation of serum VEGF-D levels has the potential of a diagnostic test with a contribution to the stratification of the difficult of prebioptically differentiating adnexal tumours.

• MeSH
• Humans MeSH
• Lymphangiogenesis MeSH
• Biomarkers, Tumor * MeSH
• Ovarian Neoplasms * diagnosis   MeSH
• Retrospective Studies MeSH
• Vascular Endothelial Growth Factor D * analysis   blood   MeSH
• Check Tag
• Humans MeSH
• Female MeSH

Úvod: Zobrazovací metody mají v diagnostice pacientů s Crohnovou chorobou nezastupitelnou úlohu. V současné době existuje několik skórovacích systémů, jejichž cílem je pomocí předem stanovených parametrů objektivizovat hodnocení zánětlivého postižení střeva. Cílem této práce bylo srovnání nálezu zánětlivého střevního postižení na koloskopii a magnetické rezonanci (MR) při použití skórovacího systému MaRIA. Materiály a metody: Pacienti s Crohnovou chorobou podstoupili v rozmezí do 2 měsíců koloskopii a MR enterografii ve Fakultní nemocnici Brno v letech 2020–2022. Aktivita onemocnění na koloskopii byla hodnocena pomocí SES-CD a Rutgeerts score, na MR pomocí MaRIA skóre (zesílení stěny, její sycení, edém a přítomnost ulcerací). Nálezy z obou zobrazovacích metod byly srovnány, koloskopie byla zvolena zlatým standardem. U každého pacienta bylo analyzováno terminální ileum, tlusté střevo (rozdělené anatomicky na čtyři segmenty) a rektum. Výsledky: V této retrospektivní studii bylo analyzováno 203 střevních segmentů u 43 po sobě jdoucích pacientů (42 % mužů). Senzitivita MR enterografie v hodnocení aktivity střevního zánětu byla 62 %, specificita 94 %. Všechny parametry určující aktivitu zánětu na MR byly signifikantně vyšší u pacientů s aktivitou dle koloskopie a celková hodnota MaRIA skóre byla rovněž vyšší v této skupině (12,76 ± 7,48 vs. 5,27 ± 3,45; p < 0,001). Senzitivita se zvýšila na 90 % při izolované analýze tenkého střeva, při analýze tlustého střeva se naopak snížila na 34 %. Závěr: V naší studii jsme prokázali shodu mezi MR s použitím MaRIA skórovacího systému a koloskopií při hodnocení střevního zánětu u pacientů s Crohnovou chorobou.

Introduction: Imaging methods have an irreplaceable role in the diagnosis of Crohn’s disease. Several scoring systems are currently available to objectify the assessment of inflammatory bowel disease using predetermined parameters. The aim of this study was to compare the findings of inflammatory bowel involvement on colonoscopy and MRI using the MaRIA scoring system. Materials and methods: Patients with Crohn’s disease underwent colonoscopy and MR-enterography at the University Hospital Brno within 2 months between 2020 and 2022. Disease activity on colonoscopy was evaluated by SES-CD and Rutgeerts score; and on MRI by MaRIA score (wall thickening, wall enhancement, edema, and presence of ulceration). Findings from both imaging modalities were compared, and colonoscopy was chosen as the gold standard. In each patient, the terminal ileum, colon (divided anatomically into 4 segments), and rectum were analyzed. Results: 203 intestinal segments in 43 consecutive patients (42% male) were analyzed in this retrospective study. The sensitivity of MR enterography in the evaluation of intestinal inflammation activity was 62% and specificity was 94%. All parameters determining the activity of inflammation on MR were significantly higher in patients with activity according to the colonoscopy, and the overall MaRIA score was also higher in this group (12.76 ± 7.48 vs. 5.27 ± 3.45; P < 0.001). Sensitivity increased to 90% in isolated small bowel analysis, but decreased to 34% in colonic analysis. Conclusion: In our study, we demonstrated concordance between MRI using the MaRIA scoring system and colonoscopy in the evaluation of intestinal inflammation in patients with Crohn’s disease.

• Keywords
• MaRIA skóre,
• MeSH
• Crohn Disease * diagnostic imaging   diagnosis   pathology   MeSH
• Adult MeSH
• Colonoscopy methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Intestine, Large diagnostic imaging   pathology   MeSH
• Organ Dysfunction Scores MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

PURPOSE: This study aimed to compare general ophthalmologists, retina specialists, and Aireen AI screening system with the clinical reference standard of a three-member high-level expert committee for diabetic retinopathy (DR) in the evaluation of fundus images for DR. PATIENTS AND METHODS: The study was designed as a diagnostic, multicenter, cross-sectional, non-randomized diagnostic study. The cohort included in the clinical investigation consisted of 1274 patients with diabetes mellitus (DM) type I or II. Each patient underwent one-field fundus photography using a non-mydriatic camera to assess findings of DR. One hundred and nineteen subjects (9.3%) were excluded from the clinical investigation based on Aireen system assessment. In the clinical investigation, all images were assessed at three independent levels of evaluation: 1) general ophthalmologists (GO) - without subspecialty training in the retina; 2) retina specialists (RS); and 3) system Aireen. In cases where there may be disagreements amongst groups, the image is referred for assessment by the Diabetic Retinopathy Board (DRB). RESULTS: The overall prevalence of any DR was 31.9% (368 cases out of 1154 DM), according to the DRB. Overall concordance between AI system Aireen and GO and RS assessments in the detection of DR from fundus photography occurred in 734 cases (63.6%). The number of disagreements between Aireen system, GO and RS evaluation occurred in 420 (36.4%) cases. Sensitivity for GO was 87.0% (95% CI: 83.6; 90.4), for RS was 82.9% (95% CI: 79.1; 86.7), and for AI system Aireen was 92.1% (95% CI: 89.3; 94.9). Specificity was 76.5% (95% CI: 73.5; 79.5), 81.2% (95% CI: 78.5; 83.9), and 90.7% (95% CI: 88.7; 92.7) for GO, RS and AI system Aireen, respectively. CONCLUSION: This real-world study illustrates the potential use of AI system Aireen in screening for DR. It exhibits higher sensitivity and specificity compared to telemedicine evaluation of one field fundus image.

• Publication type
• Journal Article MeSH

Screening for tuberculosis infections (TBI) using the tuberculin skin test or interferon-gamma release assays (IGRA) is crucial in controlling the global TB burden. This study evaluates the performance of a new IGRA for the detection of T-cell responses against Mycobacterium tuberculosis. Blood samples from 34 adults with tuberculosis disease (TB) and from 30 children with TB, TBI or without TB were analyzed using the prototype Quan-T-Cell TB (EUROIMMUN). The pediatric samples were additionally measured using the established QuantiFERON-TB Gold Plus assay (Qiagen). Clinical performance and inter-assay concordance were analyzed. The prototype Quan-T-Cell TB yielded positivity rates of 88.2% and 100% in adults with TB and children with TBI, respectively, at a specificity of 93.8%. Comparison between the two IGRAs showed positive, negative and overall agreement rates of 100%, 93.8% and 96.3%, respectively, with a kappa score of 0.924 indicating almost perfect agreement. Our study shows promising results of the new prototype Quan-T-Cell TB, as reflected by high concordance with the final diagnosis in adults and children and performance comparable to that of the QuantiFERON IGRA. In individual cases, the data suggest that the prototype Quan-T-Cell TB may be even more consistent with TBI-related clinical findings. Unlike the QuantiFERON assay, the Quan-T-Cell TB has a predefined borderline range, which is advantageous as it may help to differentiate non-specific variation near the cut-off, and fewer sample tubes are required per analysis. The new Quan-T-Cell TB may therefore be a good alternative to the established QuantiFERON IGRA for TBI screening. Further assay optimization is underway, including evaluation studies based on larger patient and control cohorts.

• MeSH
• Child MeSH
• Adult MeSH
• Interferon-gamma MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Mycobacterium tuberculosis * immunology   MeSH
• Child, Preschool MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• T-Lymphocytes * immunology   MeSH
• Interferon-gamma Release Tests * methods   MeSH
• Tuberculosis * diagnosis   immunology   microbiology   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH