Liver metastases can appear in different forms in magnetic resonance imaging.Contrary to popular belief,while radiologists report hypovascular or hypervascular metastatic lesions,exceptional examples may be detected i...Liver metastases can appear in different forms in magnetic resonance imaging.Contrary to popular belief,while radiologists report hypovascular or hypervascular metastatic lesions,exceptional examples may be detected in various tumors.The aim of this article is to improve this review by presenting rare and atypical examples of liver metastasis,as well as cases that might potentially be misdiagnosed as metastases during the process of differential diagnosis.展开更多
The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy compute...The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy computed tomography and diffusion weighted magnetic resonance imaging are useful in the early diagnosis of acute pancreatitis,and dual energy computed tomography is also useful in severity assessment and prognosis prediction.Walled off necrosis is an important complication in terms of prognosis,and it is important to know its radiological findings and distinguish it from pseudocyst.展开更多
Radiological imaging findings may contribute to the differentiation of malignant biliary obstruction from choledocholithiasis in the etiology of acute cholangitis.
The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infection...The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infections,benign and malignant lesions,and vascular diseases are examples of lesions.Care should be taken to make the proper diagnosis at the time of diagnosis in order to initiate therapy promptly.Our task is currently made simpler by radiological imaging techniques.展开更多
BACKGROUND Chronic otitis media(COM)is an inflammatory disease that lasts for a long time.It is common in developing countries.Hearing loss can result from COM.The relationship between variations in middle ear anatomy...BACKGROUND Chronic otitis media(COM)is an inflammatory disease that lasts for a long time.It is common in developing countries.Hearing loss can result from COM.The relationship between variations in middle ear anatomy and COM was investigated in our study.AIM To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals.METHODS This retrospective study included 500 patients with COM and 500 healthy controls.The presence of those variants was determined:Koerner’s septum,facial canal dehiscence,high jugular bulb,jugular bulb dehiscence,jugular bulb diverticulum,sigmoid sinus anterior location and deep tympanic recesses.RESULTS A total of 1000 temporal bones were examined.The incidences of these variants were respectively(15.4%-18.6%),(38.6%-41.2%),(18.2%-4.6%),(2.6%-1.2%),(1.2%-0%),(8.6%-0%),(0%-0%).It was observed that only high jugular bulb(P<0.001)and anteriorly located sigmoid sinus frequencies(P=0.002)in the case group were statistically significantly higher than the control groups.CONCLUSION COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease.We didn't find a positive correlation between COM and Koerner’s septum and facial canal defect.We ended up with a significant conclusion with the variants of dural venous sinuses-high jugular bulb,dehiscence of jugular bulb,diverticulum of jugular bulb and anteriorly located sigmoid sinus-that have been studied less and frequently associated with inner ear illnesses.展开更多
BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and ima...BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.展开更多
BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences...BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions(ADRs)in Turkey.METHODS The study was cross-sectional and analytical.Data were obtained through a questionnaire.The questionnaire was sent via e-mail.The survey was sent to 2030 physicians and 670 participated.RESULTS The most appropriate definition of PV was correctly defined by 53.9%of the participants.The most important goal of PV was correctly defined by 54.9%of the participants,and 27.3%of the participants were aware of the Turkish Pharmacovigilance Center.Nonsurgical physicians had better PV knowledge than surgical physicians.A total of 80.9%of the physicians who encountered ADRs,filled in the ADR notification form,and 8.8%received training on how to fill in the form.PV knowledge of the clinicians was not sufficient.Although half of the physicians encountered ADRs,the rates of seeing and filling in the ADR form were low.CONCLUSION Few of the physicians followed the current information about PV.The results provide more comprehensive data on PV practices and ADR reporting at a national level.展开更多
BACKGROUND The effect of the sympathetic nervous system on peripheral arteries causes vasoconstriction when smooth muscle cells in the walls of blood vessels contract,which leads to narrowing of arteries and reduction...BACKGROUND The effect of the sympathetic nervous system on peripheral arteries causes vasoconstriction when smooth muscle cells in the walls of blood vessels contract,which leads to narrowing of arteries and reduction of the blood flow.AIM To compare sympathetic vasomotor activation of the brachial arteries in healthy subjects and patients with painful diabetic neuropathy;and therefore,to assess whether there is significant vasomotor dysfunction of medium sized arteries in diabetic neuropathy.METHODS The study included 41 diabetic neuropathy patients and 41 healthy controls.Baseline diameter and flow rate of the brachial arteries were measured.Then,using a bipolar stimulus electrode,a 10 mA,1 Hz electrical stimulus was administered to the median nerve at the wrist level for 5 s.The brachial artery diameter and blood flow rate were re-measured after stimulation.RESULTS In the control group,the median flow rate was 70.0 mL/min prior to stimulation and 35.0 mL/min after stimulation,with a statistically significant decrease(P<0.001),which is consistent with sympathetic nervous system functioning(vasoconstriction).In the diabetic neuropathy group,median flow rate before the stimulation was 35.0 mL/min.After stimulation,the median flow rate was 77.0 mL/min;thus,no significant decrease in the flow rate was detected.In the control group,the median brachial artery diameter,which was 3.6 mm prior to stimulation,decreased to 3.4 mm after stimulation,and this decrease was also statistically significant(P=0.046).In the diabetic neuropathy group,the median brachial artery diameter increased from 3.4 mm to 3.6 mm following nerve stimulation.Once again,no narrowing was observed.CONCLUSION Our research suggests that diabetic neuropathy results in significant vasomotor dysfunction of medium sized peripheral arteries.Physiological vasoconstriction in response to sympathetic activation is impaired in diabetic neuropathy.展开更多
BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physi...BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physiology.AIM To determine the tracheobronchial branching angles in pediatric and adult populations by using the multislice computed tomography(CT)and minimum intensity projection(MinIP)technique,which is a non-invasive method.METHODS Our study was carried out retrospectively.Patients who underwent contrast and non-contrast CT examination,whose anatomically and pathophysiologically good tracheobronchial system and lung parenchyma images were obtained,were included in the study.Measurements were made in the coronal plane of the lung parenchyma.In the coronal plane,right main bronchus-left main bronchus angle,right upper lobe bronchus-intermedius bronchus angle,right middle lobe bronchus-right lower lobe bronchus angle,left upper lobe bronchus-left lower lobe bronchus angle were measured.RESULTS The study population consisted of 1511 patients,753 pediatric(mean age:13.4±4.3;range:1-18 years)and 758 adults(mean age:54.3±17.3;range:19-94 years).In our study,tracheal bifurcation angle was found to be 73.3°±13.7°(59.6°-87°)in the whole population.In the pediatric group,the right-left main coronal level was found to be higher in boys compared to girls(74.6°±12.9°vs 71.2°±13.9°,P=0.001).In the adult group,the right-left main coronal level was found to be lower in males compared to females(71.9°±12.9°vs 75.8°±14.7°,P<0.001).CONCLUSIONS Our study,with the number of 1511 patients,is the first study in the literature with the largest number of patient populations including pediatric and adult demographic data,measuring the angle values of the tracheobronchial system using multislice CT and MinIP technique.Study data will not only be a guide during invasive procedures,but it can also guide studies to be done with imaging methods.展开更多
BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequently referred conditions to the gastrointestinal outpatient clinic.The pathophysiology of IBS has not been determined with certainty.Visceral hypersensi...BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequently referred conditions to the gastrointestinal outpatient clinic.The pathophysiology of IBS has not been determined with certainty.Visceral hypersensitivity is indicated as one of the pathophysiologies.The sympathetic nervous system is primarily in charge of controlling the arteries,and its effect is vasospasm in the medium and large arteries,resulting in decreased blood flow.AIM To demonstrate,using Doppler evaluation of the brachial artery,that sympathetic activity impairs vasomotor performance due to autonomic neuropathy,which we believe is associated with IBS.METHODS There were 58 participants in the study.The control group consisted of 29 healthy patients,while the remaining 29 patients had been diagnosed with IBS.Patients who met the Rome IV criteria and had IBS were included in the study.People with known polyneuropathy or non-IBS chronic conditions that can progress were excluded from the trial,as were those with essential hypertension,diabetes mellitus,cardiovascular disease,or peripheral arterial disease,and patients diagnosed with anxiety or depression.Those with moderate to severe carpal tunnel syndrome or a median nerve lesion due to trauma were also excluded from the trial.A Doppler probe was used to measure the baseline diameter and flow rates of the brachial artery from 2 cm superior to the antecubital fossa.The Doppler probe remained stationary throughout the experiment,allowing for continuous measurements.Then,to activate the sympathetic fibers,an electrical stimulus for 5 s with an intensity of 10 mA and a frequency of 1 Hz was applied to the median nerve at the wrist level via the bipolar stimulus electrode.The artery diameter and flow rates were measured again immediately following the fifth stimulus.RESULTS In healthy persons with no history of chronic illness,there was a statistically significant decrease in flow rate after stimulation(P<0.001).In addition,stimulation resulted in a statistically significant reduction in the diameter of the brachial artery(P<0.001).Patients diagnosed with IBS had statistically significant vasodilation and an increase in flow rate.CONCLUSION Sympathetic stimulation causes a reduction in vascular diameter and blood flow,whereas it has the reverse effect on IBS patients.In investigating the involvement of autonomic neuropathy in the development of IBS,significant changes in brachial artery Doppler parameters were observed before and after stimulation of the median nerve with low-current sensory stimulation.This method is thought to be more user-friendly and comfortable than other methods described in the literature.展开更多
BACKGROUND Ileus is a pathological condition of the abdomen that presents as a medical emergency.It is characterized by potential complications such as perforation and ischemia,which can lead to significant morbidity ...BACKGROUND Ileus is a pathological condition of the abdomen that presents as a medical emergency.It is characterized by potential complications such as perforation and ischemia,which can lead to significant morbidity and mortality if not promptly addressed.The successful management of ileus relies heavily on the timely and precise identification of the condition.While conventional radiography(CR)is commonly used as the primary diagnostic tool,its accuracy in identifying obstructions ranges from 46%to 80%.Furthermore,the diagnostic accuracy of identifying the location and etiology of intestinal obstruction by CR is limited,therefore making computed tomography(CT)the ideal imaging modality in this regard.AIM To determine the presence of acute bowel obstruction(BO)on abdominal CT scenogram images and the accuracy of determining its possible location,taking into account the experience of the observers.METHODS A retrospective screening was conducted on an ensemble of 46 individuals who presented to the emergency department between January 2021 and January 2022 with severe abdominal pain and were subsequently monitored for suspected ileus.The abdominal CT scans of these patients were assessed by three radiologists with varying levels of experience(1,3,and 10 years)at different intervals(1 mo apart).The evaluation focused on determining the presence or absence of BO,as well as identifying the potential location of the obstruction(small bowel or large bowel).The study employed Kappa statistics to assess inter observer variances,while the McNamer test was used to evaluate obstruction and segmentation discrepancies between observations.A significance level of P<0.05 was determined to indicate statistical significance.RESULTS Out of the total sample size of 46 patients,15 individuals(32.6%)were identified as female,while the remaining 31 individuals(67.4%)were identified as male.The ultimate diagnosis of 42 instances(91.3%)indicated ileus resulting from mechanical obstruction(MO).Among these patients,14(33%)experienced obstruction in the large bowel(LB),while 28(66%)experienced obstruction in the small bowel(SB).The initial evaluation yielded sensitivity rates of 76.19%,83.31%,and 83.33%,and diagnostic accuracy rates of 69.56%,76.08%,and 80.43%for the detection of BO among the three observers.The initial study revealed that the average sensitivity of three observers in detecting the presence of ileus caused by MO was 80.94%,while the diagnostic accuracy was 75.35%.Based on the first evaluation,the senior observer demonstrated the highest sensitivity(85.71%),negative predictive value(92.60%),and diagnostic accuracy(80.43%)when accurately estimating the thick and thin segmentation,as per the final diagnosis.There was no statistically significant disparity observed in the sensitivities pertaining to the identification of ileus during the second assessment,as well as the precise determination of the segment level inside the LB or SB,when comparing the second and third observers.Nevertheless,although there was no statistically significant alteration in the detection rate of ileus by the first observer,there was a notable rise in the accuracy rate of segment estimating(73.91%).The senior assessor had a higher level of accuracy in assessing the existence of ileus and segmentation compared to the other evaluators in both evaluations.CONCLUSION The findings of our study indicate that the sensitivity and accuracy rates of abdominal CT scenogram scans in diagnosing acute MOs are similar to or greater than those of CR.Additionally,the study revealed that radiologists with more experience demonstrated a higher likelihood of accurately predicting the existence and potential localization of MO compared to their less experienced counterparts.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is continuing.The disease most commonly affects the lungs.Since the beginning of the pandemic thorax computed tomography(CT)has been an indispensable imaging m...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is continuing.The disease most commonly affects the lungs.Since the beginning of the pandemic thorax computed tomography(CT)has been an indispensable imaging method for diagnosis and follow-up.The disease is tried to be controlled with vaccines.Vaccination reduces the possibility of a severe course of the disease.AIM The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score(CT-SS)and CORADS score obtained during hospitalization.METHODS The files of patients hospitalized between April 1,2021 and April 1,2022 due to COVID-19 were retrospectively reviewed.A total of 224 patients who were older than 18 years of age,whose vaccination status was accessible,whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive,and who had a Thorax CT scan during hospitalization were included in the study.RESULTS Among the patients included in the study,52.2%were female and the mean age was 61.85 years.The patients applied to the hospital on the average 7th day of their complaints.While 63 patients were unvaccinated(Group 1),20 were vaccinated with a single dose of CoronaVac(Group 2),24 with a single dose of BioNTech(Group 3),38 with 2 doses of CoronaVac(Group 4),40 with 2 doses of BioNTech(Group 5),and 39 with 3 doses of vaccine(2 doses of CoronaVac followed by a single dose of BioNTech,Group 6).CT-SS ranged from 5 to 23,with a mean of 12.17.RESULTS CT-SS mean of the groups were determined as 14.17,13.35,11.58,10.87,11.28,10.85,respectively.Accordingly,as a result of the comparisons between the groups,the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups.As the vaccination rates increased,the rate of typical COVID-19 findings on CT was found to be significantly lower.CONCLUSION Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs.It also reduces the risk of severe disease and decreases CT Severity Scores.This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.展开更多
The relationship between coronavirus disease-19(COVID-19)and cardiovascular diseases has been an important issue.Therefore,cardiac biomarkers and cardiac imaging have an important place in the diagnostic phase.It is i...The relationship between coronavirus disease-19(COVID-19)and cardiovascular diseases has been an important issue.Therefore,cardiac biomarkers and cardiac imaging have an important place in the diagnostic phase.It is important to know the relationship of biomarkers in COVID-19 so that we can understand the diagnosis of the disease,the predicted course and results after diagnosis.展开更多
Intrathyroidal ectopic thymus(IET)is defined as an ectopic thymus tissue that is generally found incidentally and rarely in the thyroid gland in the pediatric group.It occurs as a result of disruption of the embryolog...Intrathyroidal ectopic thymus(IET)is defined as an ectopic thymus tissue that is generally found incidentally and rarely in the thyroid gland in the pediatric group.It occurs as a result of disruption of the embryological migration path and the settling of the thymus tissue into the thyroid gland.In the differential diagnosis,it is mostly confused with thyroid nodules.Although thyroid nodules are less common in children than adults,the rate of malignancy is much higher.Therefore,knowing the general ultrasound findings of IET better may prevent unnecessary invasive attempts and surgical procedures.In this article,we tried to compile the key imaging findings of IET.展开更多
文摘Liver metastases can appear in different forms in magnetic resonance imaging.Contrary to popular belief,while radiologists report hypovascular or hypervascular metastatic lesions,exceptional examples may be detected in various tumors.The aim of this article is to improve this review by presenting rare and atypical examples of liver metastasis,as well as cases that might potentially be misdiagnosed as metastases during the process of differential diagnosis.
文摘The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma,diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis.Dual energy computed tomography and diffusion weighted magnetic resonance imaging are useful in the early diagnosis of acute pancreatitis,and dual energy computed tomography is also useful in severity assessment and prognosis prediction.Walled off necrosis is an important complication in terms of prognosis,and it is important to know its radiological findings and distinguish it from pseudocyst.
文摘Radiological imaging findings may contribute to the differentiation of malignant biliary obstruction from choledocholithiasis in the etiology of acute cholangitis.
文摘The mediastinum is where thoracic lesions most frequently occur in young patients.The histological spectrum of diseases caused by the presence of several organs in the mediastinum is broad.Congenital lesions,infections,benign and malignant lesions,and vascular diseases are examples of lesions.Care should be taken to make the proper diagnosis at the time of diagnosis in order to initiate therapy promptly.Our task is currently made simpler by radiological imaging techniques.
文摘BACKGROUND Chronic otitis media(COM)is an inflammatory disease that lasts for a long time.It is common in developing countries.Hearing loss can result from COM.The relationship between variations in middle ear anatomy and COM was investigated in our study.AIM To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals.METHODS This retrospective study included 500 patients with COM and 500 healthy controls.The presence of those variants was determined:Koerner’s septum,facial canal dehiscence,high jugular bulb,jugular bulb dehiscence,jugular bulb diverticulum,sigmoid sinus anterior location and deep tympanic recesses.RESULTS A total of 1000 temporal bones were examined.The incidences of these variants were respectively(15.4%-18.6%),(38.6%-41.2%),(18.2%-4.6%),(2.6%-1.2%),(1.2%-0%),(8.6%-0%),(0%-0%).It was observed that only high jugular bulb(P<0.001)and anteriorly located sigmoid sinus frequencies(P=0.002)in the case group were statistically significantly higher than the control groups.CONCLUSION COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease.We didn't find a positive correlation between COM and Koerner’s septum and facial canal defect.We ended up with a significant conclusion with the variants of dural venous sinuses-high jugular bulb,dehiscence of jugular bulb,diverticulum of jugular bulb and anteriorly located sigmoid sinus-that have been studied less and frequently associated with inner ear illnesses.
文摘BACKGROUND This article examines primary hepatic angiosarcoma(PHA)and fat-poor angiomyolipoma(AML),two uncommon vascular cancers.Clinical decisions in these situations are frequently aided by pathology reports and imaging techniques.Uncommon malignant tumors of the vascular endothelium include PHA.Another diagnosis that should not be overlooked when employing contrastenhanced MR and contrast-enhanced computed tomography(CT)imaging techniques is fat-poor AML,one of the uncommon vascular tumors of the liver.In both conditions,biopsy is the primary means of diagnosis.CASE SUMMARY In our article,besides the diagnosis of PHA,fat-poor AML,one of the other rare vascular tumors of the liver,is mentioned.In the case,a 50-year-old female patient with VHL Syndrome was admitted to our hospital with nonspecific lesions such as right upper quadrant pain,weight loss,and nausea.Abdominal ultrasonography(US)revealed a hypoechoic heterogeneous lesion with occasional faint contours.In computed tomography,it was observed as a hyperdense nodular lesion in segment 4.Magnetic resonance imaging(MRI)revealed that the lesion did not contain fat.In connection with the known history of VHL Syndrome,we first evaluated the possibility of AML.Thereupon,a histopathological sample was taken and the diagnosis was made as fat-poor AML with 5%fat content.CONCLUSION In conclusion,PHA in our case report and fat-poor AML in our clinic are two uncommon liver vascular malignancies with comparable incidences.Important imaging techniques like contrast-enhanced US(CEUS),CECT,and CEMRI give us substantial advantages in both cases.However,a biopsy is used to provide the final diagnosis.
文摘BACKGROUND Pharmacovigilance(PV)is the activities and scientific studies conducted to detect,evaluate,understand or prevent adverse reactions and other drug-related problems.AIM To define the awareness and experiences of the clinicians on PV and adverse drug reactions(ADRs)in Turkey.METHODS The study was cross-sectional and analytical.Data were obtained through a questionnaire.The questionnaire was sent via e-mail.The survey was sent to 2030 physicians and 670 participated.RESULTS The most appropriate definition of PV was correctly defined by 53.9%of the participants.The most important goal of PV was correctly defined by 54.9%of the participants,and 27.3%of the participants were aware of the Turkish Pharmacovigilance Center.Nonsurgical physicians had better PV knowledge than surgical physicians.A total of 80.9%of the physicians who encountered ADRs,filled in the ADR notification form,and 8.8%received training on how to fill in the form.PV knowledge of the clinicians was not sufficient.Although half of the physicians encountered ADRs,the rates of seeing and filling in the ADR form were low.CONCLUSION Few of the physicians followed the current information about PV.The results provide more comprehensive data on PV practices and ADR reporting at a national level.
文摘BACKGROUND The effect of the sympathetic nervous system on peripheral arteries causes vasoconstriction when smooth muscle cells in the walls of blood vessels contract,which leads to narrowing of arteries and reduction of the blood flow.AIM To compare sympathetic vasomotor activation of the brachial arteries in healthy subjects and patients with painful diabetic neuropathy;and therefore,to assess whether there is significant vasomotor dysfunction of medium sized arteries in diabetic neuropathy.METHODS The study included 41 diabetic neuropathy patients and 41 healthy controls.Baseline diameter and flow rate of the brachial arteries were measured.Then,using a bipolar stimulus electrode,a 10 mA,1 Hz electrical stimulus was administered to the median nerve at the wrist level for 5 s.The brachial artery diameter and blood flow rate were re-measured after stimulation.RESULTS In the control group,the median flow rate was 70.0 mL/min prior to stimulation and 35.0 mL/min after stimulation,with a statistically significant decrease(P<0.001),which is consistent with sympathetic nervous system functioning(vasoconstriction).In the diabetic neuropathy group,median flow rate before the stimulation was 35.0 mL/min.After stimulation,the median flow rate was 77.0 mL/min;thus,no significant decrease in the flow rate was detected.In the control group,the median brachial artery diameter,which was 3.6 mm prior to stimulation,decreased to 3.4 mm after stimulation,and this decrease was also statistically significant(P=0.046).In the diabetic neuropathy group,the median brachial artery diameter increased from 3.4 mm to 3.6 mm following nerve stimulation.Once again,no narrowing was observed.CONCLUSION Our research suggests that diabetic neuropathy results in significant vasomotor dysfunction of medium sized peripheral arteries.Physiological vasoconstriction in response to sympathetic activation is impaired in diabetic neuropathy.
文摘BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physiology.AIM To determine the tracheobronchial branching angles in pediatric and adult populations by using the multislice computed tomography(CT)and minimum intensity projection(MinIP)technique,which is a non-invasive method.METHODS Our study was carried out retrospectively.Patients who underwent contrast and non-contrast CT examination,whose anatomically and pathophysiologically good tracheobronchial system and lung parenchyma images were obtained,were included in the study.Measurements were made in the coronal plane of the lung parenchyma.In the coronal plane,right main bronchus-left main bronchus angle,right upper lobe bronchus-intermedius bronchus angle,right middle lobe bronchus-right lower lobe bronchus angle,left upper lobe bronchus-left lower lobe bronchus angle were measured.RESULTS The study population consisted of 1511 patients,753 pediatric(mean age:13.4±4.3;range:1-18 years)and 758 adults(mean age:54.3±17.3;range:19-94 years).In our study,tracheal bifurcation angle was found to be 73.3°±13.7°(59.6°-87°)in the whole population.In the pediatric group,the right-left main coronal level was found to be higher in boys compared to girls(74.6°±12.9°vs 71.2°±13.9°,P=0.001).In the adult group,the right-left main coronal level was found to be lower in males compared to females(71.9°±12.9°vs 75.8°±14.7°,P<0.001).CONCLUSIONS Our study,with the number of 1511 patients,is the first study in the literature with the largest number of patient populations including pediatric and adult demographic data,measuring the angle values of the tracheobronchial system using multislice CT and MinIP technique.Study data will not only be a guide during invasive procedures,but it can also guide studies to be done with imaging methods.
文摘BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequently referred conditions to the gastrointestinal outpatient clinic.The pathophysiology of IBS has not been determined with certainty.Visceral hypersensitivity is indicated as one of the pathophysiologies.The sympathetic nervous system is primarily in charge of controlling the arteries,and its effect is vasospasm in the medium and large arteries,resulting in decreased blood flow.AIM To demonstrate,using Doppler evaluation of the brachial artery,that sympathetic activity impairs vasomotor performance due to autonomic neuropathy,which we believe is associated with IBS.METHODS There were 58 participants in the study.The control group consisted of 29 healthy patients,while the remaining 29 patients had been diagnosed with IBS.Patients who met the Rome IV criteria and had IBS were included in the study.People with known polyneuropathy or non-IBS chronic conditions that can progress were excluded from the trial,as were those with essential hypertension,diabetes mellitus,cardiovascular disease,or peripheral arterial disease,and patients diagnosed with anxiety or depression.Those with moderate to severe carpal tunnel syndrome or a median nerve lesion due to trauma were also excluded from the trial.A Doppler probe was used to measure the baseline diameter and flow rates of the brachial artery from 2 cm superior to the antecubital fossa.The Doppler probe remained stationary throughout the experiment,allowing for continuous measurements.Then,to activate the sympathetic fibers,an electrical stimulus for 5 s with an intensity of 10 mA and a frequency of 1 Hz was applied to the median nerve at the wrist level via the bipolar stimulus electrode.The artery diameter and flow rates were measured again immediately following the fifth stimulus.RESULTS In healthy persons with no history of chronic illness,there was a statistically significant decrease in flow rate after stimulation(P<0.001).In addition,stimulation resulted in a statistically significant reduction in the diameter of the brachial artery(P<0.001).Patients diagnosed with IBS had statistically significant vasodilation and an increase in flow rate.CONCLUSION Sympathetic stimulation causes a reduction in vascular diameter and blood flow,whereas it has the reverse effect on IBS patients.In investigating the involvement of autonomic neuropathy in the development of IBS,significant changes in brachial artery Doppler parameters were observed before and after stimulation of the median nerve with low-current sensory stimulation.This method is thought to be more user-friendly and comfortable than other methods described in the literature.
文摘BACKGROUND Ileus is a pathological condition of the abdomen that presents as a medical emergency.It is characterized by potential complications such as perforation and ischemia,which can lead to significant morbidity and mortality if not promptly addressed.The successful management of ileus relies heavily on the timely and precise identification of the condition.While conventional radiography(CR)is commonly used as the primary diagnostic tool,its accuracy in identifying obstructions ranges from 46%to 80%.Furthermore,the diagnostic accuracy of identifying the location and etiology of intestinal obstruction by CR is limited,therefore making computed tomography(CT)the ideal imaging modality in this regard.AIM To determine the presence of acute bowel obstruction(BO)on abdominal CT scenogram images and the accuracy of determining its possible location,taking into account the experience of the observers.METHODS A retrospective screening was conducted on an ensemble of 46 individuals who presented to the emergency department between January 2021 and January 2022 with severe abdominal pain and were subsequently monitored for suspected ileus.The abdominal CT scans of these patients were assessed by three radiologists with varying levels of experience(1,3,and 10 years)at different intervals(1 mo apart).The evaluation focused on determining the presence or absence of BO,as well as identifying the potential location of the obstruction(small bowel or large bowel).The study employed Kappa statistics to assess inter observer variances,while the McNamer test was used to evaluate obstruction and segmentation discrepancies between observations.A significance level of P<0.05 was determined to indicate statistical significance.RESULTS Out of the total sample size of 46 patients,15 individuals(32.6%)were identified as female,while the remaining 31 individuals(67.4%)were identified as male.The ultimate diagnosis of 42 instances(91.3%)indicated ileus resulting from mechanical obstruction(MO).Among these patients,14(33%)experienced obstruction in the large bowel(LB),while 28(66%)experienced obstruction in the small bowel(SB).The initial evaluation yielded sensitivity rates of 76.19%,83.31%,and 83.33%,and diagnostic accuracy rates of 69.56%,76.08%,and 80.43%for the detection of BO among the three observers.The initial study revealed that the average sensitivity of three observers in detecting the presence of ileus caused by MO was 80.94%,while the diagnostic accuracy was 75.35%.Based on the first evaluation,the senior observer demonstrated the highest sensitivity(85.71%),negative predictive value(92.60%),and diagnostic accuracy(80.43%)when accurately estimating the thick and thin segmentation,as per the final diagnosis.There was no statistically significant disparity observed in the sensitivities pertaining to the identification of ileus during the second assessment,as well as the precise determination of the segment level inside the LB or SB,when comparing the second and third observers.Nevertheless,although there was no statistically significant alteration in the detection rate of ileus by the first observer,there was a notable rise in the accuracy rate of segment estimating(73.91%).The senior assessor had a higher level of accuracy in assessing the existence of ileus and segmentation compared to the other evaluators in both evaluations.CONCLUSION The findings of our study indicate that the sensitivity and accuracy rates of abdominal CT scenogram scans in diagnosing acute MOs are similar to or greater than those of CR.Additionally,the study revealed that radiologists with more experience demonstrated a higher likelihood of accurately predicting the existence and potential localization of MO compared to their less experienced counterparts.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is continuing.The disease most commonly affects the lungs.Since the beginning of the pandemic thorax computed tomography(CT)has been an indispensable imaging method for diagnosis and follow-up.The disease is tried to be controlled with vaccines.Vaccination reduces the possibility of a severe course of the disease.AIM The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score(CT-SS)and CORADS score obtained during hospitalization.METHODS The files of patients hospitalized between April 1,2021 and April 1,2022 due to COVID-19 were retrospectively reviewed.A total of 224 patients who were older than 18 years of age,whose vaccination status was accessible,whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive,and who had a Thorax CT scan during hospitalization were included in the study.RESULTS Among the patients included in the study,52.2%were female and the mean age was 61.85 years.The patients applied to the hospital on the average 7th day of their complaints.While 63 patients were unvaccinated(Group 1),20 were vaccinated with a single dose of CoronaVac(Group 2),24 with a single dose of BioNTech(Group 3),38 with 2 doses of CoronaVac(Group 4),40 with 2 doses of BioNTech(Group 5),and 39 with 3 doses of vaccine(2 doses of CoronaVac followed by a single dose of BioNTech,Group 6).CT-SS ranged from 5 to 23,with a mean of 12.17.RESULTS CT-SS mean of the groups were determined as 14.17,13.35,11.58,10.87,11.28,10.85,respectively.Accordingly,as a result of the comparisons between the groups,the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups.As the vaccination rates increased,the rate of typical COVID-19 findings on CT was found to be significantly lower.CONCLUSION Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs.It also reduces the risk of severe disease and decreases CT Severity Scores.This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.
文摘The relationship between coronavirus disease-19(COVID-19)and cardiovascular diseases has been an important issue.Therefore,cardiac biomarkers and cardiac imaging have an important place in the diagnostic phase.It is important to know the relationship of biomarkers in COVID-19 so that we can understand the diagnosis of the disease,the predicted course and results after diagnosis.
文摘Intrathyroidal ectopic thymus(IET)is defined as an ectopic thymus tissue that is generally found incidentally and rarely in the thyroid gland in the pediatric group.It occurs as a result of disruption of the embryological migration path and the settling of the thymus tissue into the thyroid gland.In the differential diagnosis,it is mostly confused with thyroid nodules.Although thyroid nodules are less common in children than adults,the rate of malignancy is much higher.Therefore,knowing the general ultrasound findings of IET better may prevent unnecessary invasive attempts and surgical procedures.In this article,we tried to compile the key imaging findings of IET.
