BackgroundIodinated X-ray contrast media are the most commonly used contrast agents in the world with an annual application of 40-50 million. New non-ionic contrast agents are subdivided into low osmolar agents such as iopromide and iso-osmolar agents such as iodixanol. Regarding different biochemical characteristics, these agents are different in the allergic reactions and contrast enhancement and final lesion conspicuity.ObjectivesThis study was carried out to compare allergic adverse effects and contrast enhancement between iodixanol and iopromide.Patients and MethodsOne-hundred and twenty patients who were referred for abdominal CT scan to Besat Hospital were included in this study. Patients were randomly divided into two groups (A and B). Group A received 100 cc iodixanol (300 mgI/mL) and group B received 100 cc iopromide (300 mgI/ml) by power injector. CT examination was performed using Helical CT Scanner (Somatom, Siemens, Germany). Sixty seconds after injection, images were obtained and enhancement of port, liver and aorta were determined. Allergic adverse effects were recorded one hour and up to one week after injection.ResultsIodixanol produced a significantly greater enhancement of the hepatic, aorta and portal vein than iopromide (P < 0.01). Sixty seconds after injection, associated pain and heat sensation were less frequent in iodixanol in comparison with iopromide (P = 0.03). Immediate reactions such as nausea and vomiting were less frequent in iodixanol (P = 0.01). Late skin reactions such as rash was more frequent in iodixanol (P < 0.01).ConclusionsIodixanol is safe and is better tolerated in the early phase of injection with better contrast enhancement and lesion conspicuity. Mild late skin rash is its disadvantage.
Mammography is the best technique for screening and identifying patients with non-mass-like breast lesions and microcalcifications. Considering the false positive and false-negative results, ultrasound is not a perfect screening modality. Future studies are recommended to study the value of ultrasound in the detection of high-risk breast cancer patients.
Numerous investigations have been performed on the role of the transforming growth factor‐β1 (TGF‐β1) pathway in the development of chronic liver diseases (CLDs); however, they failed to explain the underlying mechanism of its pathogenesis, suggesting that other alternative pathways might have been overlooked. The involvement of yes‐associated protein1 (YAP1) has been attributed to liver fibrosis; yet, the precise function of this protein has not been fully understood. Therefore, this study aimed to investigate the activity of the YAP1 pathway in human liver cirrhosis (regardless of its causality) and its correlation with the TGF‐β1 and sonic hedgehog (SHH) pathways. In this case–control study, the immunohistochemical and quantitative real‐time polymerase chain reaction analyses were carried out to determine the activation of the YAP1 pathway in patients with liver cirrhosis (n = 38) and control 1 individuals (n = 10). The western blot analysis and ELISA method were also performed to assess the SHH and TGF‐β1 pathways. Although significantly increased expression of cytoplasmic YAP1 was found in patients with liver cirrhosis (P < 0.045), the rate of the nuclear YAP1 expression was similar to that of the control 1 subjects. Moreover, the hepatic expression of amphiregulin (AREG), known as the YAP1 target, along with proteins involved in the TGF‐β1 pathway was significantly elevated in all cirrhotic patients, compared with the control subjects. Our results showed that the increased activity of the TGF‐β1 pathway is strongly associated with the expression of AREG, denoting a direct and positive relationship between the TGF‐β1 and YAP1 pathways. It seems that, unlike the TGF‐β1 and SHH pathways, the YAP1 pathway does not play a significant role in the development of liver cirrhosis.
Background: Diagnostic radiology by the use of ionizing radiation plays a main contribution in the collective dose of human population. Knowing the radiation dose received by patients during a radiological examination is essential to prevent the excess health risk of exposure. Objectives: The aim of this study was to estimate the collective dose and calculate the cancer risk probability due to common radiological procedures in four radiology imaging centers of Iran. Patients and Methods: Four hundred seventy patients who underwent different radiological examinations including the skull, chest, abdomen, pelvis, lumbar, cervical and thoracic regions in four radiology centers of Hamadan, Iran were studied. The patients' entrance surface dose (ESD) was measured, and eventually, the effective dose (ED) was calculated. These parameters were compared with the reported values and international standard levels. Finally, the risk of cancer was determined by two different methods proposed in international commission on radiological protection (ICRP) 103.
Introduction:The early prenatal identification of fetal gender is of great importance. Accurate prenatal identification is currently only possible through invasive procedures. The present study was conducted to determine the accuracy and sensitivity of ultrasound fetal gender identification.Materials and Methods:The present cross-sectional study was conducted on 150 women in their 11th and 12th weeks of pregnancy in Hamadan in 2014. Ultrasound imaging performed in the 11th and 12th weeks of pregnancy for fetal gender identification identified the fetus either as a girl, a boy, or as a “gender not assigned.” Frequency, sensitivity, specificity, positive and negative predictive values, and accuracy of the gender identification was assessed using SPSS version 20. The significant level was 0.05 in all analyses.Results:Of the total of 150 women, the gender was identified as female in 32 (21.3%), as male in 65 (43.3%), and not assigned in 53 (35.3%); overall, gender identification was made in 64.6% of the cases. A total of 57 male fetuses were correctly identified as boys, and 8 female fetuses were wrongly identified as boys. As for the female fetuses, 31 were correctly identified as girls, and 1 was wrongly identified as a boy. The positive predictive value for the ultrasound imaging gender identification was 87.6% for the male fetuses and 96.8% for the female fetuses.Conclusion:The present study had a much higher gender identification accuracy compared to other studies. The final success of fetal gender identification was about 91% in the 11th and 12th weeks of pregnancy.
Background and Objectives: Laparoscopic surgery (LS) is the most important diagnostic technique for the detection of causes of infertility; however, this method is accompanied by some setbacks. Given the noninvasive nature and cost-effectiveness of hysterosalpingography (HSG), it is widely used as the first-line approach for the evaluation of the patency of the fallopian tubes and uterine anomalies in female infertility. Herein, we aimed to compare the diagnostic values of HSG with LS in the assessment of patency of the fallopian tubes and peritoneal disease in infertile women. Materials and Methods Results:The sensitivity, specificity, and accuracy of HSG for the detection of unilateral and bilateral tubal occlusion were 75%, 91.2%, 89.5%, 75%, 97.2%, and 96.6%, respectively. Furthermore, false-positive and false-negative rates of HSG for the detection of unilateral and bilateral tubal occlusion were 8.7% and 25%, respectively. The accuracy of HSG in detecting uterine anomalies and hydrosalpinx were 93.3% and 93.9%, respectively. Peritubal adhesion and TOA were detected in 61% of the cases with normal HSG. In addition, of the nine cases of bilateral tubal occlusion detected by HSG, six cases were confirmed to have bilateral occlusion using laparoscopy. The comparison between HSG and LS techniques showed a significant difference in diagnosis of distal fallopian tube occlusion (P=0.021) and unilateral fallopian tube occlusion (P<0.001) among infertile women. The comparison between HSG and LS techniques demonstrated a significant difference in diagnosis of TOA (P<0.001) and peritubal adhesion (P=0.033). Conclusion:It seems that the findings of HSG regarding occlusion, hydrosalpinx, and uterine anomalies are reliable. However, due to its low sensitivity in detecting peritubal adhesion, performing LS before initiation of treatment in these patients is necessary to rule out adhesion and to confirm tubal patency.
Introduction In December 2019, a case series of pneumonia associated with seafood and wet animal market was reported as coronavirus disease 2019 (COVID-19) in Wuhan, Hubei, China. The COVID-19 less frequently affects the pediatric group, and asymptomatic children are commonly reported. This feature is important due to the potential transmissibility of COVID-19 through these cases. There is a variety of atypical clinical symptoms and imaging manifestations among children infected with COVID-19. Case presentation We report two sisters with COVID-19 pneumonia who had close contact with their 77-year-old grandmother. Their grandmother expired with a confirmed diagnosis of COVID-19. The older sister (15 years old) firstly presented with severe cough, fever, dyspnea, diarrhea, and lymphopenia. A chest computed tomography (CT) scan showed atypical lobar pneumonic infiltration only in the left lower lobe. The younger sister (6 years old) was affected the following day with milder symptoms (i.e., fever and cough). Her chest CT scan demonstrated typical mild generalized patchy ground-glass opacity with interlobular septal thickening scattered in both lungs. The CT presentation of their grandmother showed typical bilateral white lungs with crazy paving appearance. The standard regimen for both sisters was administrated, and the patients’ respiratory conditions improved after 5 days of treatment. Both cases were discharged with good general conditions. Conclusion Children are considered potentially important causes of COVID-19 transmission. The symptoms in children are milder, and clinicians should be aware of taking a definite history of infected family members. Atypical clinical symptoms and imaging features are more common in children than adults; therefore, it is necessary to identify the typical and atypical imaging patterns of COVID-19 pneumonia in the pediatric population.
Background Coronavirus disease 2019 (COVID-19) has spread widely throughout the world and become a pandemic disease. In this study we decided to investigate the chest computed tomography (CT) findings in COVID-19 patients in Hamadan, west of Iran. Methods This cross-sectional study was conducted on 101 patients with confirmed COVID-19 infection from February to March 2020. Demographic, clinical, laboratory and chest CT information of identified COVID-19 patients were assessed. Results Totally, 101 patients diagnosed with COVID-19 were included. The mean age of the patients was 55.21 ± 14.08 years and 54% (53.47%) of them were male. With regards to clinical manifestations, 82.18%, 72.28% and 54.46% of COVID-19 patients had dry cough, dyspnea and fever, respectively and 44.5% had lymphopenia. The right lower lobe was the most common (69%) and severe involved lobe followed by left lower lobe, right middle lobe, and lingual; however, anterior segment of upper lobes showed least involvement with abnormality in the late course of disease. The most common pattern is ground glass opacity, but atypical patterns such as round pneumonia, moderate to severe plural effusion and segmental lobar collapse consolidation was seen without evidence of mediastinal adenopathy, cavitation or nodule. Chest X ray (CXR) was not sensitive method as a first line imaging because 34.65% of them were normal. Conclusion CXR is not sensitive method as first line imaging too (34.65% normal first CXR), but Chest CT is very sensitive and nonspecific modality for diagnosis of COVID – 19. Lower lobe and posterior basal predominance involvements were seen in most cases. About 12% showed atypical chest CT features.
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