Campylobacter jejuni is a leading cause of bacterial gastroenteritis worldwide; however, the molecular determinants associated with symptomatic infection remain incompletely understood. In this study, an immunoproteomic approach was applied to characterize the antigenic landscape of C. jejuni during acute campylobacteriosis and to identify infection-associated proteins targeted by the human humoral immune response. Sera from patients with laboratory-confirmed acute campylobacteriosis (Group A) and asymptomatic individuals without recent gastrointestinal disease (Group B) were used to immunocapture bacterial proteins, followed by nano-liquid chromatography-tandem mass spectrometry analysis. A total of 418 and 517 immunoreactive proteins were identified in Groups A and B, respectively, with a large shared core repertoire, indicating extensive background immune recognition of conserved bacterial components. Functional annotation revealed that metabolic enzymes and ribosomal proteins dominated the immunoproteome in both groups. However, semi-quantitative emPAI analysis identified selective differences associated with acute infection. Group A sera preferentially recognized proteins involved in stress response, motility, secretion, and virulence-related functions, whereas Group B sera predominantly recognized housekeeping proteins. Bioinformatic prediction and network analyses identified immunoreactive proteins with features compatible with secretion-associated virulence factors, including proteins related to the flagellar export apparatus and the cytolethal distending toxin complex. Additionally, several immunoreactive proteins carried C-terminal acidic E-Block-like motifs previously described in Type IV secretion system effectors from other bacterial pathogens. Although the present approach does not directly demonstrate secretion, surface exposure, or translocation of the predicted proteins, these findings provide insight into infection-associated immune recognition patterns and identify candidate virulence-associated antigens that warrant future experimental validation.
OBJECTIVE:To evaluate the utility of the Fibromyalgia Survey Questionnaire (FSQ) as a screening tool for fibromyalgia (FM) in patients with inflammatory arthritis (IA) and to determine optimal cutoff points according to arthritis disease activity. METHODS:Patients with rheumatoid arthritis (RA), axial spondyloarthritis (SpA), and psoriatic arthritis (PsA), with and without comorbid fibromyalgia (FM) at a 1:1 ratio were invited to participate in this cross-sectional study. FM status was defined by an expert physician's diagnosis. Disease activity indexes were recorded. Participants completed the FSQ through a structured online interview. ROC analysis and the area under the curve (AUC) were calculated to identify the optimal FSQ cutoff values. RESULTS:A total of 152 IA patients were included (72% RA, 11% SpA, and 17% PsA), 51% of whom had comorbid FM. The ability of the FSQ to differentiate comorbid FM among patients in remission or with low disease activity (n=80) was high (AUC=0.896), showing 88% sensitivity and 88% specificity at a cutoff >12. In contrast, the FSQ performance was lower in patients with moderate to very high disease activity (n=72, AUC=0.695), with 83% sensitivity and 56% specificity at a cutoff >15. CONCLUSIONS:The FSQ is a useful screening tool for identifying comorbid FM in IA patients with low disease activity or in remission, with performance comparable to the general population (cutoff value >12). Results should be interpreted cautiously in those with active disease. These findings may facilitate the recognition and management of comorbid FM in IA patients.
Radiologists have a central role in building understanding of many diseases. In multidisciplinary settings, medical imaging has a role in diagnosing, assessing severity, monitoring progress and delineating anatomical structures involved in diseases. Imaging also helps to elucidate models of disease pathogenesis. In this review, imaging features of COVID-19 lung disease are analysed in the context of pathophysiological processes in different phases of the disease. Radiological evidence is presented for the central role of vasculopathic phenomena in both the acute and post-acute phases of COVID-19. From the outset of the COVID-19 pandemic, a lack of formal collaborative interdisciplinary systems to build models of pathophysiology led to widespread misunderstanding of the lung disease. Specifically, the lack of a systematic multidisciplinary approach to share concepts relating to radiological evidence with collaborators from other medical and scientific fields led to the use of terminology which was, and remains, potentially inappropriate or misleading. In conclusion, imaging is essential to multidisciplinary understanding of COVID-19 vascular pathophysiology. Current evidence should lead to adapted diagnostic guidelines for long COVID. Formation of collaborative systems to build interdisciplinary understanding of disease pathogenesis across all medical and scientific specialties should be a priority at the outset of any future pandemic.
Background and Objective: The cost of imaging and interventions in the surgical field varies between countries and sometimes within different regions of the same country. Procedural cost takes into account equipment, consumables, operating room, surgical, anesthetic and nursing teams, radiology, medications, and hospital stay. Health care systems therefore face an incredible burden related to investigations and surgical procedures. The aim of this study was to collect costs of imaging and interventions for kidney calculi across different hospitals and health care systems in the world. Methods: An online shared Google spreadsheet was created by the European Association of Urology Young Academic Urology urolithiasis group. The survey consisted of the cost of four radiological imaging (ultrasound of the urinary tract [USS], plain X-ray radiography of the abdomen including kidneys, ureter, and bladder [XRKUB], noncontrast-enhanced computerized tomography [CTKUB], and contrast-enhanced CT with urographic phase [CTU]) and seven interventions (endoscopic laser treatment of renal stones, ureteroscopic treatment or extraction of ureteral stones, percutaneous nephrolithotomy (PCNL), insertion of ureteral stent, diagnostic ureteroscopy, and cystolitholapaxy). A chosen representative from each country collected and collated the data, and this was converted to Euros (€). Key Findings and Limitations: Data were collected from 32 countries, which include Turkey, Armenia, Nepal, Uzbekistan, Brazil, Chile, Qatar, Peru, Israel, Singapore, Thailand, Colombia, Argentina, Saudi Arabia, Asia, North America, 15 countries from the European continent, and the United States. The mean cost of USS, XRKUB, CTKUB, and CTU was 51.3 € (range: 2-160 €), 27.1 € (range: 2.5-187 €), 105.8 € (range: 19-405 €), and 171.5 € (range: 19-674 €), respectively. Similarly, the cost of endoscopic laser treatment of renal stones, ureteroscopic treatment/extraction of ureteral stones, PCNL, insertion of ureteral stent, diagnostic ureteroscopy, and cystolitholapaxy was 1942.6 € (range: 100-7887 €), 1626.8 € (range: 80-9787 €), 2884.6 € (range: 110-12642 €), 631 € (range: 110-2787 €), 861.6 € (range: 3-2667 €), and 876 € (range: 19-3457 €), respectively. Wide differences in cost between countries were found within the study. Conclusions and Clinical Implications: This study highlights the significant economic impact of kidney stone management on health care systems worldwide. There seem to be significant disparities between costs, and this study shows the social and economic inequalities in health care access, which can differ significantly between private and public health care. These results can aid policymakers to address these disparities and perhaps to learn from other health care providers.
Introduction: Urolithiasis guidelines still rely on the maximum stone diameter to propose treatment strategy, although this measure is known to have many pitfalls. Stone volume (SV) could represent a more accurate measurement, helping to plan the treatment or follow-up. Various methods to measure SV have been proposed. We aimed to compare different methods to estimate SV. Methods: Fifteen stones (human and artificial) were assessed. Real SV was measured using the water displacement method. Volume estimation included three diameter-based formulas (Ackerman, 4/3 Pi r3 and r3/2) and two 3D segmentation methods (Horos and Kidney Stone Calculator [KSC]). All measurements were done by a single operator. Spearman correlation test and comparative analyses were conducted between the real and the estimated SV. Results: Compared with real SVs, Ackerman and r3/2 formulas estimated volume accurately in 2/15 (13%) of stones each. No accurate measurement was reported using the sphere formula. KSC did estimate volume accurately in 4/15 (27%) stones compared with the reference SV; Horos did it in 7/15 (47%) stones. Both segmentation methods presented strong correlation coefficients (r = 0.9642 and 0.9659, p < 0.0001), while formula correlation was moderate (r = 0.7531, p < 0.0001). Conclusion: Formulas and segmentation methods for SV estimation resulted in divergent outcomes. Segmentation methods (Horos and KSC) presented higher accuracies in SV estimation, compared with real SV. Formulas were the least accurate.
