Pulmonary embolism (PE) is a common disorder with high mortality and usually results from deep vein thrombosis (DVT) of lower extremities. 1 Although they represent different aspects of the same process, PE and DVT are generally evaluated with different imaging methods. In current clinical practice, CT pulmonary angiography (CTPA) is used as the first line imaging modality in PE diagnosis, whereas Doppler ultrasonography is the initial modality in the diagnosis of DVT. 2-4 A single reliable test that can accurately assess both pulmonary and lower extremity vasculature and concretely show the presence or absence of a clot is highly desirable. For this purpose, combined pulmonary CTPA and indirect CT venography has been introduced as a one-stop-shop imaging technique for venous thromboembolism (VTE). However, the technique is not applied on routine basis due to concerns of increased radiation dose. 5 Pulmonary MRI has become feasible with the advent of fast acquisition techniques. MRI is particularly useful in patients with suspected PE who have contraindications for CT scanning (i.e. pregnancy, allergy to iodine-containing contrast medium), or in those in whom radiation exposure is a major concern. 6 Comprehensive MRI of VTE can be achieved by combined pulmonary and lower extremity MRI with or without use of contrast medium. Unenhanced imaging of pulmonary arteries (PAs) and
SUMMARYBrucellosis is an endemic disease in various regions of the world. Testicular abscess is a very rare complication of brucellosis which can be misdiagnosed as a testicular mass and may lead to unnecessary orchiectomy. To our knowledge there are only eight reported cases in the literature of a brucellar testicular abscess. We present a case of testicular abscess due to brucellosis diagnosed with serologic tests and color Doppler sonography, and treated with antibiotics and fine needle aspiration.
We investigated the antioxidant and anti-inflammatory effects of propolis on bleomycin induced lung fibrosis and compared these effects to prednisolone treatment. Forty rats were divided into four groups of ten: group 1 was treated with intratracheal infusion of 0.2 ml physiological saline followed by daily treatment with 0.5 ml physiological saline for 20 days. In the remaining groups (groups 2 - 4), 5 mg/kg bleomycin was given via the trachea. Rats in group 2 were given 0.5 ml physiological saline. Rats in group 3 were treated with 100 mg/kg propolis, and 10 mg/kg prednisolone was given to rats in group 4. The treatments for all groups were continued for 20 days. On postoperative day 21, blood and lung samples were taken for biochemistry, histopathology and electron microscopy evaluation. We compared oxidative stress parameters and found lower malondialdehyde and myeloperoxidase levels, and higher total sulfhydryl levels and catalase activities for the bleomycin + propolis group than for the bleomycin and bleomycin + prednisolone groups. The highest mean fibrosis score was detected in the bleomycin group. Although the mean fibrosis scores of the bleomycin + propolis and bleomycin + prednisolone groups were not significantly different, electron microscopy revealed that propolis diminished bleomycin induced lung fibrosis more effectively than prednisolone. The effects of propolis might be due to its potent antioxidant and anti-inflammatory properties.
AIM:To investigate the use of Augmented Reality (AR) technology as it contributes to spinal surgery education with the free-hand technique, and might reduce the error ratio.
MATERIAL and METHODS:Ten candidates, with anatomy education but no surgical experience, applied 36 pedicle screws with C2-C3 posterior transpedicular fixation technique to nine vertebrae models produced via a three-dimensional (3D) printer.
RESULTS:Using AR to apply pedicle screws to the experimental vertebrae model increased the safety screw ratio significantly. In comparison of Grade 0 screws to other grades: 6/18 screws (33.3%) in the free-hand technique Group (n=18), and 14/18 screws (77.8%) in the AR Group (n=18), were measured for screw insertion safety ratios. The difference was statistically significant (p=0.018). The resemblance between our results and the results of previous studies researching supportive systems indicates our 3D printed vertebra model might be a helpful educational material. CONCLUSION: AR increases the safety ratio of cervical pedicle screw fixation significantly. The parameters investigated and used for the production of vertebrae models in this study can be used for experimental material production for future studies to investigate pedicle screw positioning.
Objectives
This study aims to investigate whether variables such as body mass index (BMI), size of the cement with screw augmentation area (CSA), distance between the base of tibial plate and the deepest point of the defect area (DPDA) may cause any mechanical problems leading to deterioration in tibiofemoral alignment or impact clinical outcomes when the surgeon utilizes bone cement with screw augmentation (BCSA) technique in the treatment of moderate non-contained tibial bone defects in total knee arthroplasty (TKA).
Patients and methods
This cross-sectional study, conducted between March 2018 and March 2019, included 37 knees of 28 patients (4 males, 24 females; mean age 71.3±8.9; range, 55 to 86 years) with moderate tibial bone defects requiring treatment with BCSA during primary TKA. Patients with BMI >30 were scored with Hospital for Special Surgery (HSS) score for clinical outcomes; besides, CSA, DPDA, and tibiofemoral alignment were calculated on plain X-rays.
Results
Mean BMI was 34.1±5.7 (range, 24.9 to 45.9). Patients had a mean follow-up period of 44±13.9 (range, 28 to 75) months. Mean postoperative CSA was 98.2±35.3 (range, 42 to 180) mm2 and DPDA was 7.4±2.6 (range, 3.5 to 12.9) mm. Mean HSS score at last follow-up was 88.0±7.5 (range, 71 to 97).
Conclusion
Bone cement with screw augmentation technique was associated with satisfactory clinical outcomes and tibiofemoral alignment was not significantly deviated in patients with high BMI. We determined that neither the depth of DPDA nor the size of CSA had any correlation with clinical outcomes.
Background:
Lungs are the primary organ of involvement of COVID-19, and the severity of pneumonia in COVID-19 patients is an important cause of morbidity and mortality.
Aim:
We aimed to evaluate the visual and quantitative pneumonia severity on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) and compare the CT findings with clinical and laboratory findings.
Methods:
We retrospectively evaluated adult COVID-19 patients who underwent chest CT, clinical scores, laboratory findings, and length of hospital stay. Two independent radiologists visually evaluated the pneumonia severity on chest CT (VSQS). Quantitative CT (QCT) assessment was performed using a free DICOM viewer, and the percentage of the well-aerated lung (%WAL), high-attenuation areas (%HAA) at different threshold values, and mean lung attenuation (MLA) values were calculated. The relationship between CT scores and the clinical, laboratory data, and length of hospital stay were evaluated in this cross-sectional study. The student's t-test and chi-square test were used to analyze the differences between variables. The Pearson correlation test analyzed the correlation between variables. The diagnostic performance of the variables was assessed using receiver operating characteristic (ROC) analysis was used.
Results:
The VSQS and QCT scores were significantly correlated with procalcitonin, d-dimer, ferritin, and C-reactive protein levels. Both VSQ and QCT scores were significantly correlated with disease severity (p<0.001). Among the QCT parameters, the %HAA-600 value showed the best correlation with the VSQS (r=730,p<0.001). VSQS and QCT scores had high sensitivity and specificity in distinguishing disease severity and predicting prolonged hospitalization.
Conclusion:
The VSQS and QCT scores can help manage the COVID-19 and predict the duration of hospitalization.
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