Evaluation of the effect of Muller muscle-conjunctival resection on meibomian glands by meibography

ABSTRACT Purpose: To evaluate the effect of upper eyelid ptosis repairwith Muller muscle-conjunctival resection on meibomian gland function and ocular surface parameters. Methods: Thirty-eight patients who underwent ptosis repair with Muller muscle-conjunctival resection were retrospectively reviewed. Meibomian gland loss, Ocular Surface Disease Index OXFORD score, meiboscore, and noninvasive keratograph break-up time were measured preoperatively and at 1st, 3rd, and 6th months postoperatively. Results: Noninvasive keratograph break-up time values decreased significantly at 1st and 3rd months postoperatively compared to the preoperative level, but were similar to the preoperative level at 6th months postoperatively (p<0.001 and p=0.628, respectively). Ocular surface disease index, OXFORD score, meibomian gland loss, and meiboscore values increased significantly in the 1st and 3rd postoperative months compared to the preoperative period, but these values decreased to preoperative levels in the 6th postoperative month (p<0.001 and p>0.05, respectively). Conclusion: There is a transient deterioration in meibography findings and OSDI score in the early postoperative period afterMuller muscle-conjunctival resection. Patients undergoing Muller muscle-conjunctival resection may require topical lubricants, especially in the first 3 postoperative months.

Unilateral hemi-central retinal artery occlusion as a presenting sign of Susac syndrome

ABSTRACT A young woman presented at our clinic with sudden visual loss in the right eye, recurrent vertigo, and right-sided tinnitus. We performed a complete ophthalmological evaluation. This revealed effects of the condition on the small arterioles of the peripheral retina. Susac syndrome is characterized by the clinical triad of retinal arteriolar occlusions, cochleovestibular manifestations, and encephalopathy (which can be identified by neuroimaging abnormalities). Early diagnosis and immunosuppressive therapy improved the patient's visual acuity and the remission of her other symptoms. Hemi-central retinal artery occlusion is an atypical neuro-ophthalmological finding in this disease. However, its identification as a sign of Susac syndrome may facilitate timely diagnosis and accurate treatment.

Navigating Dry Eye Research: A Comprehensive Review of Etiology, Clinical Trials, Patents, and Recent Advancements.

BACKGROUND: Millions of people worldwide suffer from dry eye disease. Dry eye, a multifunctional condition of the ocular surface, typically occurs in conjunction with an unbalanced tear film. With increasing age, the dry eye problem becomes worse. Aqueous-deficit dry eye and evaporative dry eye are the two traditional classifications for dry eye. Various examination tools are used to diagnose dry eye. Clinical trials are conducted in four phases to check the safety and efficacy of drugs. The quick clearance from the precorneal space is ensured by the eye's advanced defense mechanism. It restricts the integrated medicine's entry into the eyes, resulting in a usually low bioavailability for topical eyedrops. In this study, we focus on recently developed formulations for curing dry eye. OBJECTIVE: This review's goal was to outline the etiology, clinical discovery and development, patents, and recent advancements for dry eye disease. RESULTS: The current study has described the widespread incidence of dry eye, which was found to be more common as people aged and recently developed formulations are treating dry eyes. According to research, novel formulations are enhancing ocular drug delivery. CONCLUSION: In this review, etiology, clinical data, dry eye formulation patents, and recent advancements are all included.

PET-CT Defined Micro-Vascular Dysfunction and Cardiac Allograft Vasculopathy Risk Factors in Heart Transplant Recipients.

Microvascular dysfunction (MVD) is considered a form of cardiac allograft vasculopathy (CAV), independently associated with poor prognosis after heart transplantation (HTX). It is unknown whether traditional risk factors for CAV are also applicable to MVD. We retrospectively analyzed factors associated with MVD in 94 HTX recipients who completed a PET scan after a normal baseline left heart catheterization excluding epicardial CAV. MVD was defined by abnormal PET blood flow. The mean age was 52 ± 14 and MVD was found in 49 patients (53%). No donor risk factors were significantly associated with recipient MVD. Recipients risk factors for MVD included-diabetes mellitus (51% vs. 27%, p = 0.016) and hypertension (78% vs. 49%, p = 0.004) in patients with and without MVD, respectively. In a multivariate model, recipient hypertension and diabetes were the only significant determinants of MVD development (OR = 2.63, 95% CI [1.69-36.98], p = 0.009 and OR 2.1, 95% CI [1.10-15.38], p = 0.035, respectively). In conclusion, MVD was more associated with metabolic risk determinants rather than traditional CAV risk factors.

Prognostic value of the monocyte-to-high-density lipoprotein-cholesterol ratio in ACS patients: A systematic review and meta-analysis.

BACKGROUND: Globally, diseases of the cardiovascular system stand as the principal contributors to mortality and are anticipated to show an upward trajectory. The occurrence of Acute Coronary Syndrome (ACS) has been linked to underlying inflammatory processes. The monocyte-to-high-density lipoprotein-cholesterol (MHR) ratio has garnered significant attention as a prognostic biomarker, encapsulating the synergistic roles of inflammation and lipid metabolism in the pathophysiology of cardiovascular diseases, including ACS. AIMS: This meta-analysis examines the prognostic MHR ratio in ACS patients. METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library databases to identify the relevant meta-analyses up to February 26, 2024. The findings were aggregated into risk ratios with 95% confidence intervals. RESULTS: Eleven studies, with 7421 patients, were included. Low MHR levels compared to high MHR levels were associated with statistically significantly lower in-hospital mortality (0.9% vs. 5.5%; respectively; p<0.001), 3-month mortality (4.4% vs. 11.2%; p = 0.02), 6-month follow-up mortality (4.0% vs. 10.2%; p = 0.03), 1-year mortality (4.2%, vs. 10.2%; p<0.001), as well as long-term follow-up mortality (7.5% vs. 13.7%; p<0.001). CONCLUSIONS: MHR has both good predictive properties for mortality and MACE (short- and long-term). Data indicate that MHR may improve in-hospital and long-term cardiovascular risk prediction. It may, therefore, be an effective tool for risk re-estimation and the selection of patients for whom intensive lipid-lowering treatment may be particularly useful.

Forensic Diatom Analysis: Where Do We Stand and What Are the Latest Diagnostic Advances?

Background: diatoms are unicellular algae that have been used for more than a century for forensic purposes to diagnose drowning, with more or less success depending on the historical era. Although many years have passed, scientific research on diatoms has never ceased, which testifies to their enduring allure in forensics. Of course, diatom research has evolved and expanded over time, changing with the availability of new techniques and technologies. The volume of articles and their production over a period of many years has resulted in old, current, and new knowledge on diatoms being scattered over a large number of books and articles. Objectives: the purpose of this narrative literature review is, therefore, to summarize all this information and bring it together in a single work that can be useful for those who are studying diatoms and their usefulness for forensics for the first time, for those who are looking for proven methods of analysis, and finally for those who are interested in exploring new frontiers of research. Methods: a comprehensive literature search that included all studies dealing with the applications of diatoms in forensic science was performed in the most popular electronic databases. Results: traditional methods have been complemented by molecular and imaging methods and, more recently, by artificial intelligence. In addition, new biological substrates have been found for the analysis of diatoms. Conclusions: all this has led, on the one hand, to the consolidation of a whole body of knowledge on diatoms, on which this forensic analysis is still based, and, on the other hand, has opened up numerous new research directions.

Rapid Molecular Diagnostics in Vulvovaginal Candidosis.

BACKGROUND/OBJECTIVES: Vulvovaginal candidosis (VVC) is a common condition among women, with current diagnostic methods relying on clinical evaluation and laboratory testing. These traditional methods are often limited by the need for specialized training, variable performance, and lengthy diagnostic processes, leading to delayed treatment and inappropriate antifungal use. This review evaluates the efficacy of molecular diagnostic tools for VVC and provides guidance on their application in clinical practice. METHODS: A literature search was conducted using PubMed to identify studies evaluating rapid diagnostic tests specifically for vulvovaginal Candida isolates. Inclusion criteria focused on studies utilizing molecular diagnostics for the detection of Candida species in VVC. Articles discussing non-vaginal Candida infections, non-English studies, and animal or in vitro research were excluded. RESULTS: Twenty-three studies met the inclusion criteria, predominantly evaluating nucleid acid amplification tests/polymerase chain reaction (NAAT/PCR) assays and DNA probes. PCR/NAAT assays demonstrated high sensitivity and specificity (>86%) for VVC diagnosis, outperforming conventional diagnostic methods. Comparatively, DNA probes, while simpler, exhibited lower sensitivity. The included studies were mostly observational, with only one randomized controlled trial. Emerging diagnostic technologies, including artificial intelligence and integrated testing models, show promise for improving diagnostic precision and clinical outcomes. CONCLUSIONS: Molecular diagnostics offer a significant improvement in VVC management, though traditional methods remain valuable in resource-limited settings.

Ocular Toxoplasmosis: Advances in Toxoplasma gondii Biology, Clinical Manifestations, Diagnostics, and Therapy.

Toxoplasma gondii, an obligate intracellular parasite, is a globally prevalent pathogen capable of infecting a wide range of warm-blooded animals, including humans. Ocular toxoplasmosis (OT), a severe manifestation of T. gondii infection, can lead to potentially blinding complications. This comprehensive review delves into the current understanding of T. gondii biology, exploring its complex life cycle, diverse transmission routes, and strain diversity. This article provides an in-depth analysis of the clinical manifestations of OT, which can result from both congenital and acquired infections, presenting a spectrum of signs and symptoms. The review examines various diagnostic strategies employed for OT, including clinical examination, multimodal imaging techniques such as fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA), as well as laboratory tests including serology and molecular methods. Despite extensive research, the specific mechanisms underlying ocular involvement in T. gondii infection remain elusive, and current diagnostic options have limitations. Moreover, the treatment of active and recurrent OT remains a challenge. While existing therapies, such as antimicrobial agents and immunosuppressants, can control active infections, they do not offer a definitive cure or completely prevent recurrence. The clinical endpoints for the management of active and recurrent OT are also not yet well-established, and the available treatment methods carry the potential for adverse effects. This article highlights the need for future research to elucidate the pathogenesis of OT, investigate genetic factors influencing susceptibility to infection, and develop more sensitive and specific diagnostic tools. Enhancing global surveillance, implementing robust prevention strategies, and fostering multidisciplinary collaborations will be crucial in reducing the burden of OT and improving patient outcomes. This comprehensive review aims to provide a valuable resource for clinicians, researchers, and policymakers, contributing to a better understanding of T. gondii infection and its impact on ocular health.

The impact of linked color imaging on adenoma detection rate in colonoscopy: a systematic review and meta-analysis.

Background/Aims: Colorectal cancer prevention relies on surveillance colonoscopy, with the adenoma detection rate as a key factor in examination quality. Linked color imaging (LCI) enhances lesion contrast and improves the examination performance. This systematic review and meta-analysis aimed to evaluate the effect of LCI on adenoma detection rate in adults who underwent colonoscopy. Methods: We searched the Medline, PubMed, BIREME, LILACS, and Scientific Electronic Library Online databases for randomized controlled trials comparing the use of LCI versus white light (WL), published up to March 2023. The outcomes included lesion characteristics, number of adenomas per patient, and the additional polyp detection rate. Results: Sixteen studies were included in the analysis, which showed that LCI was more accurate than WL in detecting adenomas, with an increased number of adenomas detected per patient. Although LCI performed well in terms of lesion size, morphology, and location, the subgroup analyses did not reveal any statistically significant differences between LCI and WL. The addition of LCI did not result in significant improvements in the detection of serrated lesions, and there were no differences in the withdrawal time between groups. Conclusions: LCI has been shown to be effective in detecting colonic lesions, improving the number of adenomas detected per patient and improving polyp detection rate without negatively affecting other quality criteria in colonoscopy.

Determining the Ability of Senior Dental Students to Detect Interproximal Caries Using Different Radiographic Techniques.

Objective: To evaluate the diagnostic capability of 5th-year students using digital imaging, conventional bitewing (BW) radiographs, and printed film on paper to detect interproximal caries lesions. Methods: A cross-sectional study was conducted with senior dental students. Three different radiographs: digital, BW, and printed films on paper were used; thus, nine radiographs, each with a 2-min viewing time, were considered by students along with a questionnaire. A control group of specialists from Prosthodontics and Radiology had finalized the answers prior to conducting the study. The appropriate responses were divided into five categories: R0: Intact surface, R1: Radiolucency in the outer half of enamel, R2: Radiolucency in the inner half of enamel, R3: Radiolucency in the outer half of dentin, and R4: Radiolucency in the inner half of dentin. Students' responses were analyzed using a one-way analysis of variance (ANOVA) test and a t-test. Results: Ethics for the study was obtained from the institutional committee (Reg No: BM19/9/8). When compared with the control group using ANOVA testing, the results showed good detection accuracy with a success rate of ~64 accuracy. There was a significant difference in the outcomes when detecting the presence of the caries lesion between the three diagnostic techniques (p > 0.001). In detecting the size of the carious lesion, the students' ability was recorded as poor. The highest average for detecting the presence of the carious lesion was correspondent to the printed film on paper method. Conclusions: Senior dental students have shown good accuracy in detecting the presence but not the size of interproximal caries on all radiographs viewed. Clinical Significance: Teachings and availability of diverse radiological diagnostic techniques ensured a reasonable level of understanding and use of the diagnostic caries risk assessment methodologies as required in restorative treatment planning.

Erythrasma: Pathogenesis and Diagnostic Challenges.

Erythrasma is a common chronic superficial bacterial infection caused by Corynebacterium minutissimum, a lipophilic, diphtheroid, filamentous, gram-positive bacillus and normal inhabitant of the skin flora. Commonly found in intertriginous spaces, this bacterium releases a porphyrin that causes lesions to fluoresce under a Wood's lamp, aiding diagnosis. Despite its clinical relevance, the pathogenesis remains understudied. We present a case of a 43-year-old woman with a history of hypertension, type 2 diabetes mellitus, and obesity who exhibited an erythematous eczematous plaque with characteristic coral-red fluorescence under Wood's lamp. The diagnosis was confirmed through negative skin scrapings for candidiasis and dermatophytosis. A two-week course of topical clindamycin resulted in complete resolution. Given the condition's frequent coexistence with other pathologies, accurate diagnosis and effective treatment are essential. Topical treatments are usually more convenient. The hypothesis that hydrophobic and lipophilic interactions in intertriginous areas contribute to the pathogenesis of erythrasma requires further experimental validation.

Accuracy of point-of-care SARS-CoV-2 detection using buccal swabs in pediatric emergency departments.

To optimize the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children, specimen collection and testing method are crucial considerations. Ideally, specimen collection is easy and causes minimal discomfort, and the laboratory approach is simple, accurate, and rapid. In this prospective cohort study we evaluated the accuracy of a point-of care nucleic acid device using caregiver/patient self-collected buccal swabs. Participants were recruited in 14 Canadian tertiary care pediatric emergency departments. Children <18 years of age deemed to require SARS-CoV-2 testing were eligible. Caregivers or the patient-collected buccal swabs which were tested on the ABBOTT ID NOW. The reference standard was nasopharyngeal swab specimens collected by a healthcare provider tested via laboratory reverse transcription PCR (RT-PCR). We enrolled 2,640 study participants and 14.4% (381/2,640) were SARS-CoV-2 RT-PCR-positive. Eight percent (223/2,640) and 85.0% (2,244/2,640) were concordant test-positive and concordant test-negative, respectively. Sensitivity and specificity of the investigational approach were 58.5% [95% confidence interval (CI): 53.4, 63.5] and 99.3% (95% CI: 98.9, 99.6), respectively. Cycle threshold values were lower among concordant [median 17 (15, 21)] relative to discordant [median 30 (22, 35)] swabs (P < 0.001). Sensitivity was greatest among children <4 years of age, when caregivers performed the swabs, among unvaccinated children, and those with shorter symptom duration. Across multiple pain measures, less pain was associated with buccal swab testing. Although accuracy of the buccal swab point-of-care SARS-CoV-2 test was good and negative agreement was excellent, sensitivity was only 58.5%. Concordance was greater among those with higher viral loads, and the approach involving buccal swabs was less painful.IMPORTANCETo optimize the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children, specimen collection and testing method are crucial considerations. Ideally, specimen collection is easy and causes minimal discomfort, and laboratory approach is simple, accurate, and rapid. We evaluated the accuracy and pain associated with buccal swab specimen collection by caregivers or children themselves who were tested using a point-of-care isothermal nucleic acid amplification SARS-CoV-2 test. This novel approach was compared to nasopharyngeal swab specimens tested using laboratory-based PCR tests. While negative agreement was excellent, positive percent agreement was less than 60%. Concordance was greater among those with higher viral loads, and thus, sensitivity is excellent when transmissibility is more likely to occur. Importantly, the approach involving buccal swabs was significantly less painful, and thus, children and their caregivers are more likely to agree to testing using such an approach.CLINICAL TRIALSRegistered at ClinicalTrials.gov (NCT05040763).

The value of tongue base mucosectomy in the work-up of squamous cell carcinoma of unknown primary: A Danish national cohort study.

INTRODUCTION: Squamous cell carcinoma of unknown primary in the head and neck (HNSCCUP) remains a diagnostic challenge. Tongue base mucosectomy by transoral robotic surgery (TORS-TBM) can increase the diagnostic yield and de-intensify treatment. However, the added value of TORS-TBM as an adjunct to work-up programs for HNSCCUP is unclear. Furthermore, the optimal extent of the procedure and selection criteria remain to be established. AIM: The primary aim of the present study was to assess the diagnostic yield of TORS-TBM as a supplement to a standardized work-up program, using the Danish national guidelines as an example. Secondary aims include predictive values of HPV-testing and PET/CT. METHODS: This was a national multicenter observational cohort study including all patients diagnosed with HNSCCUP from January 2013 to December 2019, who subsequently underwent TORS-TBM. In most cases HPV status was based on dual testing (p16 and HPV-DNA). Predictive values of PET/CT and HPV status were calculated. RESULTS: A total of 100 consecutive patients underwent TORS-TBM; 93 total TBMs and 7 unilateral TBMs. The primary tumor was detected in 49 % (49/100) of patients. The detection rate was 58 % (47/81) in patients with HPV-associated disease (PPV of HPV status) and 11 % (2/19) in patients with HPV-independent disease. The NPV of HPV status was 89 %. The PPV and NPV of PET/CT was 53 % and 52 %, respectively. CONCLUSION: Adding total TORS-TBM to the current Danish guideline-based work-up program on HNCCCUP patients with HPV-associated disease significantly improved the diagnostic yield.

Close, yet so far away: a phenomenology of the praecox feeling in the diagnosis of schizophrenia as intercorporeal alienness.

Debates concerning the reliability and validity of operationalized criteria and diagnostic tools have surrounded the issue of schizophrenia diagnosis and clinical decision-making related to the disorder. The notion of the praecox feeling (PF) has played a prominent role in the discussions as an example of the possibility of a rapid and potentially valid diagnosis based solely on "intuition" or a peculiar emotional experience or impression arising in a physician during an interaction with a patient with schizophrenia. In this paper, we argue that PF is enabled by the (phenomenologically understood) intercorporeal dimension of the clinical encounter. Intercorporeality in this sense denotes intertwinement between embodied expressions that may lead to feelings of connection but also, as in the case of PF, of disconnection and strangeness-the experience of alienness. Following Waldenfels, alienness ranges from the average social encounter to more extreme and peculiar forms-such as PF. To prove our point, we analyze the metaphors used by physicians in various cultural contexts (the United States, the United Kingdom, and Poland) to express the apparently ineffable experience of the PF. We focus on two dominant metaphors of distance: the first expressing spatial distance by referring to an "object in-between" the physician and the patient and the second expressing mental distance by referring to the "other-worldliness" of the patient. We interpret the object in-between metaphors as reflecting the sense of separateness and the other-worldliness metaphors as reflecting the sense of strangeness, with both meanings unified in the notion of "close remoteness." Such unsettling but speculation-provoking feeling of close remoteness may be rendered by the concept of "the eerie" (Mark Fisher). We conclude that metaphor and phenomenological analysis facilitate an understanding of the experiential profile of PF in the clinical encounter, outlining relevant clinical implications.

[Diagnostic scales for acute appendicitis in children]. / Diagnosticheskie shkaly ostrogo appenditsita u detei.

Acute appendicitis, a common medical emergency, primarily affects children, and its diagnosis can be challenging. In addition to methods such as abdominal ultrasound, predictive clinical scales are used, such as the Alvarado scale and others, which categorize risk in pediatric patients. Given the lack of consensus on exact criteria, this review seeks to identify and analyze 22 prediction scales used in the diagnosis of acute appendicitis in children. The search was carried out according to the PRISMA guide, resulting in 73 articles selected from a total of 1521, with inclusion criteria focused on the pediatric population and integrated scales. The importance of predictive scales for appendicitis in children is highlighted, which incorporate clinical history, physical examination, laboratory and images to guide surgical intervention decisions. Among the most used worldwide were the Alvarado and Tzanakis scales, PAS and Heidelberg Appendicitis Score (HAS), designed specifically for pediatric patients.

Secondary Glaucoma Following Corneal Transplantation: A Comprehensive Review of Pathophysiology and Therapeutic Approaches.

Corneal transplantation is a critical surgical procedure aimed at restoring vision in patients with corneal blindness or severe damage. This review focuses on secondary glaucoma, a significant postoperative complication, with the primary objective of providing a comprehensive analysis of its pathophysiology, risk factors, diagnostic challenges, and therapeutic approaches. Unlike other reviews, this work emphasizes the interplay between inflammatory responses, corticosteroid use, and structural changes in the eye that lead to elevated intraocular pressure (IOP) after transplantation. A comprehensive review of the literature was conducted, including studies on postcorneal transplantation glaucoma, to highlight both clinical outcomes and the efficacy of current management strategies. Key findings indicate that medical treatments, such as prostaglandin analogs and beta-blockers, are effective for IOP control in the early stages, while surgical interventions, like trabeculectomy, are often necessary for more advanced cases. Diagnostic challenges, such as the difficulty of accurate IOP measurement posttransplant, are underscored, along with the importance of advanced imaging techniques for the early detection of optic nerve damage. The pathophysiology of secondary glaucoma involves a complex interaction of postsurgical inflammation, steroid-induced complications, and anatomical changes that hinder aqueous humor outflow. Diagnosis requires a combination of tonometry, gonioscopy, and imaging technologies. Management strategies range from pharmacological treatments to surgical options, with a critical focus on balancing IOP control and minimizing risks to graft survival. Clinically, these findings highlight the need for proactive and tailored management of IOP in corneal transplant patients to preserve both graft function and long-term visual outcomes. Future research should focus on improving diagnostic accuracy, developing less invasive surgical techniques, and exploring personalized medicine approaches, including genetic profiling and targeted therapies.

Precision Medicine in Periodontics: A Literature Review.

Periodontitis, a widespread health issue, requires effective prevention and management strategies due to its increasing prevalence and detrimental social consequences. The chronic inflammation associated with periodontitis also exacerbates systemic conditions, emphasizing the need for advanced approaches in addressing this public health concern. The traditional methods of periodontal diagnosis, which primarily rely on clinical indicators such as pocket depth, clinical attachment loss, mobility, and radiographic measurements of alveolar bone loss, have limitations in guiding therapy due to the intricate and multifaceted nature of periodontal diseases. Precision periodontics is the amalgamation of genomics, bioinformatics, and advanced technology, mainly biomarkers reflecting a precise patient-centered treatment. However, implementing this approach in periodontology is new due to the lack of validated periodontal biomarkers for diagnostic use. This article explores the foundations of personalized therapy in periodontal diagnosis. It discusses the current state and prospects of periodontal biomarkers as a crucial step toward realizing a precision approach in periodontal practice.

Microfluidics for detection of food pathogens: recent trends and opportunities.

Safe and healthy food is the fundamental right of every citizen. Problems caused by foodborne pathogens have always raised a threat to food safety and human health. Centers for Disease Control and Prevention (CDC) estimates that around 48 million people are affected by food intoxication, and 3000 people succumb to death. Hence, it is inevitable that an approach that is efficient, reliable, sensitive, and rapid approach that can replace the conventional analytical methods such as microbiological and biochemical methods, high throughput next-generation sequence (NGS), polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA), etc. Even though the accuracy of conventional methods is high, it is tedious; increased consumption of reagents/samples, false positives, and complex operations are the drawbacks of these methods. Microfluidic devices have shown remarkable advances in all branches of science. They serve as an alternative to conventional ways to overcome the abovementioned drawbacks. Furthermore, coupling microfluidics can improve the efficiency and accuracy of conventional methods such as surface plasma resonance, loop-mediated isothermal amplification, ELISA, and PCR. This article reviewed the progress of microfluidic devices in the last ten years in detecting foodborne pathogens. Microfluidic technology has opened the research gateway for developing low-cost, on-site, portable, and rapid assay devices. The article includes the application of microfluidic-based devices to identify critical food pathogens and briefly discusses the necessary research in this area.

Pulmonary Shunt in Critical Care: A Comprehensive Review of Pathophysiology, Diagnosis, and Management Strategies.

Pulmonary shunt, an abnormal passage of blood through the pulmonary circulation without adequate gas exchange, poses significant challenges in critical care. This comprehensive review explores the pathophysiology, diagnostic approaches, and management strategies associated with pulmonary shunt. Pulmonary shunts are classified into anatomical and physiological types, each with distinct mechanisms and implications for gas exchange. Anatomical shunts result from structural heart defects, while physiological shunts arise from ventilation-perfusion (V/Q) mismatches. Both conditions can significantly impair oxygenation and contribute to multi-organ dysfunction. This review delves into various diagnostic modalities, including clinical assessment, imaging techniques such as chest X-ray and CT scans, and advanced diagnostic methods such as V/Q scanning and echocardiography. Challenges in diagnosing pulmonary shunt are discussed, emphasizing the limitations of current tools and the need for accurate differentiation of shunt types. Management strategies are examined, covering pharmacological interventions, non-pharmacological treatments such as mechanical ventilation and prone positioning, and surgical options. Emerging therapies and innovations in treatment are also highlighted. Special considerations are given to different patient populations, including pediatric and elderly patients and those with multiple comorbidities. This review concludes with an analysis of the prognosis and outcomes associated with pulmonary shunt, focusing on short-term and long-term impacts on survival and quality of life. This review aims to enhance understanding and guide effective management practices for pulmonary shunt in critical care settings by synthesizing current knowledge and identifying areas for further research.