Urinary tract infections (UTIs) are the most common infections in both outpatient and inpatient settings, contributing significantly to morbidity, reduced quality of life, and antimicrobial overuse. Although urine culture remains the diagnostic gold standard, it poses practical limitations in clinical workflows. Rapid diagnostic methods such as urine flow cytometry (UF) offer potential for timely, reliable UTI detection. We conducted a multicenter diagnostic study to evaluate the performance of BACT-Info. and UTI-Info. flags on the UF-5000/4000 system in detecting UTIs, using presumptive Gram staining and urine culture (>10⁵ CFU/mL) as references. A total of 763 patients with suspected UTI were enrolled, and 721 patients—with uropathogenic bacteria and complete data—were included in the final analysis (384 with culture-confirmed UTI and 337 without UTI). The diagnostic value of nitrituria was highly specific, while leukocyte esterase was sensitive. For BACT-count and WBC-count of UF-5000/4000, the AUCs were 0.85 and 0.69, respectively. Using cutoffs of WBC >82.05/µL or bacteria >975.4/µL, the UTI-Info flag demonstrated 89% sensitivity, 54% specificity, 69% positive predictive value, and 82% negative predictive value. Positive and negative likelihood ratios were 1.93 and 0.20, respectively. The agreement between the BACT-Info. flag and Gram typing showed Kappa values of 0.716 for Gram-negative and 0.216 for Gram-positive bacteria when compared to culture, and 0.721 and 0.401, respectively, when compared to presumptive Gram staining. The UF-5000/4000 UTI-Info. and BACT-Info. flags show promise as a rapid UTI screening tool. The combination of these flags with urinalysis parameters, nitrite testing and leukocyte has potential to be developed into a diagnostic algorithm for early and sensitive UTI prediction. Such an approach may reduce unnecessary urine cultures and support timely, appropriate empiric antibiotic therapy. Establishing optimal cutoffs tailored to specific clinical settings is essential to enhance diagnostic accuracy and improve clinical utility.
Background/Aim: Non-Hodgkin lymphoma (NHL) is a cancer of the lymphatic system with a high incidence rate globally. Patient responses to therapies such as chemotherapy and immunotherapy often vary, which is thought to be related to individual genetic differences. The development of genomic and bioinformatic technologies allows the identification of gene variants that play a role in the effectiveness of therapy, thus opening up opportunities for personalised treatment of NHL. This study aimed to identify genetic variants that have the potential to improve the effectiveness of therapy in NHL patients.Methods: This study used a bioinformatics approach to analyse genetic and clinical data available in several database sources, including PharmGKB, HaploReg v4.2, GTEx Portal and Ensembl.Results: This study identified two significant genetic variants, rs396991 in the FCGR3A gene and rs3957357 in the GSTA1 gene, that play a role in improving the effectiveness of NHL therapy. The rs396991 variant showed increased affinity for IgG1 and effectiveness of antibody-dependent cellular cytotoxicity (ADCC) mechanism in rituximab therapy. Meanwhile, the rs3957357 variant in GSTA1 was associated with better event-free survival in patients receiving R-CHOP chemotherapy. High expression of FCGR3A gene in immune tissues and GSTA1 gene in liver also supports their biological roles in therapy response.Conclusions: Genetic variations in FCGR3A (rs396991) and GSTA1 (rs3957357) have potential as predictive biomarkers of R-CHOP therapy effectiveness in NHL patients. These findings support the application of genetic analysis as a basis for more personalised and effective therapeutic strategies in the treatment of NHL.
CHOP and R-CHOP are commonly used chemotherapy regimens for Non-Hodgkin Lymphoma (NHL). While R-CHOP has demonstrated clinical benefits, its higher cost raises concerns regarding economic efficiency, particularly in middle-income countries such as Indonesia. This study aimed to compare direct medical costs and clinical outcomes of CHOP and R-CHOP regimens among NHL patients treated at a national referral hospital in yogykarta. A retrospective cohort study was conducted using medical record data of NHL patients who received CHOP or R-CHOP chemotherapy at Dr. Sardjito General Hospital Yogyakarta, between 2020 and 2023, with follow-up extended until April 30, 2025. Clinical outcomes included overall survival (OS) and observational life years saved (LYS), calculated from treatment initiation until death or study cutoff. OS was analyzed using Kaplan–Meier and Cox proportional hazards models. Direct medical costs were calculated from the hospital perspective. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio (ICER) per LYS and interpreted using a willingness-to-pay threshold of 1–3 times Indonesia's GDP per capita. A total of 122 patients were included (61 per group). R-CHOP was associated with higher total direct medical costs than CHOP. Observational LYS and OS during the follow-up period were higher in the R-CHOP group. The ICER per additional LYS for R-CHOP was IDR 59,521,695, which falls below the commonly used WTP threshold. R-CHOP was associated with higher costs and improved observed survival compared to CHOP. However, due to methodological limitations, the findings should be interpreted cautiously and do not establish definitive long-term cost-effectiveness.
ObjectiveTo evaluate the feasibility of a modified presurgical naso-alveolar molding (PNAM) technique using segmental bowl cutting with contralateral soft-liner augmentation for correcting severely rotated premaxillae in infants with bilateral cleft lip and palate (BCLP).DesignProspective case series.SettingClinical case series conducted over a 2-year period (July 2022-July 2024) at a single center.ParticipantsThree infants diagnosed with BCLP presenting with extreme premaxillary rotation (2 rightward, 1 leftward).ResultsAll 3 premaxillae achieved the predefined midline criterion within 4 to 5 weeks (28-35 days) at an average correction rate of approximately 2 mm per week. No major complications were observed; mild transient mucosal blanching was noted in 2 infants, which resolved with appliance relief.ConclusionsSegmental cutting of the PNAM bowl with contralateral soft-liner augmentation appears to be a feasible and clinically useful adjunct for correcting severely rotated premaxillae prior to labioplasty. These preliminary findings require validation in larger, controlled studies before superiority over conventional PNAM can be established.
Our earlier work reported the association of inflammatory biomarker with a reduced breast cancer chemotherapy relative dose intensity (RDI) resulting in an unfavourable survival outcome. This current study aimed to assess the prognostic role of inflammatory biomarkers in patients with breast cancer, particularly Interleukin-8 (IL-8). This study included 168 breast cancer patients. The median follow-up was 24.3 (range 3–77) months. Kaplan-Meier and log-rank test showed that the 3-year overall survival (OS) in patients with high IL-8 plasma level (> 6.88pg/mL) were significantly lower than those with low level (≤ 6.88pg/mL) (59.6
