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Conclusions: Our results indicate increased shedding of PTCs into the urinary tract in patients with poorer glycemic control, particularly those with diabetic retinopathy and in females.

Acute lymphoblastic leukaemia is the most common childhood malignancy that remains a leading cause of death in childhood. It may be characterised by multiple known recurrent genetic aberrations that inform prognosis, the most common being hyperdiploidy and t(12;21) ETV6::RUNX1. We aimed to assess the applicability of a new imaging flow cytometry methodology that incorporates cell morphology, immunophenotype, and fluorescence in situ hybridisation (FISH) to identify aneuploidy of chromosomes 4 and 21 and the translocation ETV6::RUNX1. We evaluated this new “immuno-flowFISH” platform on 39 cases of paediatric ALL of B-lineage known to have aneuploidy of chromosomes 4 and 21 and the translocation ETV6::RUNX1. After identifying the leukaemic population based on immunophenotype (i.e., expression of CD34, CD10, and CD19 antigens), we assessed for copy numbers of loci for the centromeres of chromosomes 4 and 21 and the ETV6 and RUNX1 regions using fluorophore-labelled DNA probes in more than 1000 cells per sample. Trisomy 4 and 21, tetrasomy 21, and translocations of ETV6::RUNX1, as well as gains and losses of ETV6 and RUNX1, could all be identified based on FISH spot counts and digital imagery. There was variability in clonal makeup in individual cases, suggesting the presence of sub-clones. Copy number alterations and translocations could be detected even when the cell population comprised less than 1% of cells and included cells with a mature B-cell phenotype, i.e., CD19-positive, lacking CD34 and CD10. In this proof-of-principle study of 39 cases, this sensitive and specific semi-automated high-throughput imaging flow cytometric immuno-flowFISH method has been able to show that alterations in ploidy and ETV6::RUNX1 could be detected in the 39 cases of paediatric ALL. This imaging flow cytometric FISH method has potential applications for diagnosis and monitoring disease and marrow regeneration (i.e., distinguishing residual ALL from regenerating haematogones) following chemotherapy.

Acute lymphoblastic leukaemia is the most common childhood malignancy that remains a leading cause of death in childhood. It may be characterised by multiple known recurrent genetic aberrations that inform prognosis, the most common being hyperdiploidy and t(12;21) ETV6::RUNX1. We aimed to assess the applicability of a new imaging flow cytometry methodology that incorporates cell morphology, immunophenotype, and fluorescence in situ hybridisation (FISH) to identify aneuploidy of chromosomes 4 and 21 and the translocation ETV6::RUNX1. We evaluated this new "immuno-flowFISH" platform on 39 cases of paediatric ALL of B-lineage known to have aneuploidy of chromosomes 4 and 21 and the translocation ETV6::RUNX1. After identifying the leukaemic population based on immunophenotype (i.e., expression of CD34, CD10, and CD19 antigens), we assessed for copy numbers of loci for the centromeres of chromosomes 4 and 21 and the ETV6 and RUNX1 regions using fluorophore-labelled DNA probes in more than 1000 cells per sample. Trisomy 4 and 21, tetrasomy 21, and translocations of ETV6::RUNX1, as well as gains and losses of ETV6 and RUNX1, could all be identified based on FISH spot counts and digital imagery. There was variability in clonal makeup in individual cases, suggesting the presence of sub-clones. Copy number alterations and translocations could be detected even when the cell population comprised less than 1% of cells and included cells with a mature B-cell phenotype, i.e., CD19-positive, lacking CD34 and CD10. In this proof-of-principle study of 39 cases, this sensitive and specific semi-automated high-throughput imaging flow cytometric immuno-flowFISH method has been able to show that alterations in ploidy and ETV6::RUNX1 could be detected in the 39 cases of paediatric ALL. This imaging flow cytometric FISH method has potential applications for diagnosis and monitoring disease and marrow regeneration (i.e., distinguishing residual ALL from regenerating haematogones) following chemotherapy. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review explores the updates in the application of advanced cardiac imaging modalities, including cardiac computed tomography (CCT), cardiac magnetic resonance (CMR) imaging, and positron emission tomography (PET) in cardio-oncology. These imaging modalities have distinctive roles in baseline risk stratification, surveillance, and diagnosis of cardiotoxicity. Recent Findings: In recent years, there has been increased recognition of advanced imaging techniques in the field of cardio-oncology. With the advent of newer cancer therapeutics like immunotherapy, there has been a rise in cardiotoxicity related to these agents, including myocarditis, pericarditis, and accelerated atherosclerosis. CMR, in particular, is an essential noninvasive diagnostic test for these immunotherapy-related cardiotoxicities, albeit with diagnostic limitations depending on the disease presentation (Zhang et al. Eur Heart J. 41(18):1733-1743, 2020; Schwartz et al. Am J Med. 82(6):1109-18, 1987). Furthermore, CCT is often used in cardio-oncology patients to rule out CAD, with an expansion of its role in evaluating immune checkpoint inhibitor (ICI) myocarditis and for evaluating accelerated atherosclerosis in patients on ICI therapy (Suero-Abreu et al. JACC CardioOncol. 4(5):598-615, 2022). Coronary artery calcium (CAC) scoring on chest CT in cancer patients is a recommended risk stratification tool in addition to dedicated cardiac testing. At the same time, cardiac PET provides additional information in patients with cardiac masses. Functional testing using cardiac PET coronary flow reserve (CFR) is helpful in patients' baseline risk stratification and diagnosing microvascular disease. Summary: Cardio-oncology is a growing field with increased recognition of newer cardiotoxicities and the advent of more unique cancer treatments. Imaging techniques like echocardiogram and echocardiogram-derived global longitudinal strain (GLS) are the current workhorse for baseline risk stratification, surveillance, and cancer therapy-related cardiovascular toxicity (CTR-CVT) diagnosis. However, additional advanced cardiac imaging modalities play a unique role in risk stratification or surveillance in patients with suboptimal echocardiograms for various factors. Additionally, advanced cardiac imaging techniques are crucial in patients with abnormal echocardiograms or clinical presentations concerning for cardiotoxicity to confirm those findings or establish an accurate diagnosis—for example, CMR in ICI myocarditis or PET for cardiac masses. [ABSTRACT FROM AUTHOR]

The article discusses the relationship between acute encephalopathy and severe acute kidney injury (AKI) in critically ill patients. While kidney replacement therapy (KRT) initiation is indicated in cases of clinical uremic encephalopathy, the optimal approach for initiating KRT based on acute neurological status deterioration remains unclear. A study comparing delayed and more-delayed KRT initiation strategies found that a more-delayed approach resulted in lower rates of awakening from coma in comatose patients with severe AKI. Further research is needed to validate the benefits of KRT initiation on neurological outcomes and to clarify the mechanisms by which KRT may improve neurological status in patients with acute encephalopathy and severe AKI. [Extracted from the article]