This study aimed to determine the prevalence rate of gynecomastia, determine mean glandular breast tissue sizes, and evaluate whether there is any difference in the prevalence rate of gynecomastia ...according to age using three different reference values of glandular breast tissue size (≥5, ≥10, ≥20 mm) in the pediatric age group.
Glandular breast tissue sizes were measured retrospectively from thoracic computed tomography (CT) images taken for other reasons in 961 boys aged 1-18 years.
When each breast was evaluated separately (1,922 breasts), gynecomastia was observed in 1,001 (52.1%), 719 (37.4%), and 216 (11.2%) breasts with ≥5, ≥10, and ≥20 mm considered as reference values, respectively. A significant difference was found in terms of gynecomastia (p<0.001) and mean glandular breast tissue size (p<0.001) with respect to age.
New studies are currently needed to determine the glandular breast tissue size and the prevalence rate of gynecomastia in boys, and thoracic CT images can be used for this purpose.
This study was planned by the EACVI/ASE/Industry Task Force to Standardize Deformation Imaging to (1) test the variability of speckle-tracking global longitudinal strain (GLS) measurements among ...different vendors and (2) compare GLS measurement variability with conventional echocardiographic parameters.
Sixty-two volunteers were studied using ultrasound systems from seven manufacturers. Each volunteer was examined by the same sonographer on all machines. Inter- and intraobserver variability was determined in a true test-retest setting. Conventional echocardiographic parameters were acquired for comparison. Using the software packages of the respective manufacturer and of two software-only vendors, endocardial GLS was measured because it was the only GLS parameter that could be provided by all manufactures. We compared GLSAV (the average from the three apical views) and GLS4CH (measured in the four-chamber view) measurements among vendors and with the conventional echocardiographic parameters.
Absolute values of GLSAV ranged from 18.0% to 21.5%, while GLS4CH ranged from 17.9% to 21.4%. The absolute difference between vendors for GLSAV was up to 3.7% strain units (P < .001). The interobserver relative mean errors were 5.4% to 8.6% for GLSAV and 6.2% to 11.0% for GLS4CH, while the intraobserver relative mean errors were 4.9% to 7.3% and 7.2% to 11.3%, respectively. These errors were lower than for left ventricular ejection fraction and most other conventional echocardiographic parameters.
Reproducibility of GLS measurements was good and in many cases superior to conventional echocardiographic measurements. The small but statistically significant variation among vendors should be considered in performing serial studies and reflects a reference point for ongoing standardization efforts.
We have carefully read the article titled ‘Prognostic Nutritional Index as a Predictor of No-Reflow Occurrence in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary ...Percutaneous Coronary Intervention' and find it to be of significant interest. The no-reflow phenomenon (NRP) stands as a formidable complication of ST-segment elevation myocardial infarction (STEMI), carrying a high mortality risk. Managing NRP entails pharmacological and mechanical interventions, making its prediction a crucial aspect in the management of STEMI cases. We extend our gratitude to you and the authors for conducting this valuable and thought-provoking study. We anticipate that our insights will serve as a guide for future comprehensive studies in this dynamic area.
Background
The distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method.
Purpose
To investigate the sensitivity and specificity of ...computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients.
Material and Methods
All patients aged ≥18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated.
Results
The patients with complicated appendicitis had a significantly higher mean age (P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%.
Conclusion
Based on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.
Abstract
Aims
In pulmonary arterial hypertension (PAH), the right ventricle (RV) is exposed to an increased afterload. In response, RV mechanics are altered. Markers which would relate RV function ...and afterload could therefore aid to understand this complex response system and could be of prognostic value. The aim of our study was to (i) assess the RV-arterial coupling using ratio between RV strain and systolic pulmonary artery pressure (sPAP), in patients with PAH, and (ii) investigate the prognostic value of this new parameter over other echocardiographic parameters.
Methods and results
Echocardiograms of 65 pre-capillary PAH patients (45 females, age 61 ± 15 years) were retrospectively analysed. Fractional area change (FAC), sPAP, tricuspid annular plane systolic excursion, and RV free-wall (FW) longitudinal strain (LS) were measured. A primary endpoint of death or heart/lung transplantation described clinical endpoint. Patients who reached a clinical endpoint had worse functional capacity (New York Heart Association), reduced RV function, and higher sPAP. Left ventricle function was similar in both groups. Only RVFW LS/sPAP ratio was found as an independent predictor of clinical endpoint in multivariable analysis (hazard ratio 8.3, 95% confidence interval 3.2–21.6, P < 0.001). The RWFW LS/sPAP (cut-off 0.19) demonstrated a good accuracy for the prediction of reaching the clinical endpoint, with a sensitivity of 92% and specificity of 82.5%.
Conclusion
RVFW LS/sPAP ratio significantly predicts all-cause mortality and heart–lung transplantation, and was superior to other well-established parameters, in patients with pre-capillary PAH. We therefore propose RVFW LS/sPAP as a new prognostic echocardiographic marker.
Graphical Abstract
Graphical Abstract
Background
Transjugular intrahepatic portosystemic shunt (TIPS) is a common, effective and reliable treatment modality for portal hypertension. Migration of the TIPS stent into the right atrium is a ...rare and fatal complication.
Case presentation
We report a case of severe tricuspid regurgitation caused by a stent migrating into the right atrium in a patient hospitalized with refractory ascites due to cirrhosis.
Discussion
In this case, it is noteworthy that secondary stenting, which is necessary especially in cases of occlusion, significantly increases the risk of migration.
Conclusion
Although a rare complication, intracardiac stent migration should be considered in patients with a history of TIPS in the presence of a new heart murmur and signs of arrhythmia.
OBJECTIVEThe prevalence of obesity is increasing globally. Obesity has been shown to be associated with adverse cardiac outcomes. Current knowledge on the impairment of cardiac function caused by ...obesity in young adult population is lacking. Therefore, we aimed to evaluate the effect of obesity on cardiac deformation parameters in healthy obese individuals in early adulthood using 2D deformation imaging and 3D echocardiography. METHODSSeventy-seven volunteers with a body mass index (BMI) above 25 kg/m2 who were between 18 and 30 years of age and a control group including 40 participants were included. Patients with a history of organic heart disease, poor image quality, or current pregnancy were excluded. Participants were classified as overweight (BMI of 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). Two dimensional and 3D appropriate echocardiographic images were recorded and further analyzed with a post-processing software to obtain the global longitudinal strain (GLS) of left (LV) and right ventricle (RV). RESULTSA total of 117 subjects without metabolic syndrome were enrolled. Conventional dimensional and functional parameters as well as 3D volumetric measurements showed no significant differences among the groups. Presence of epicardial fat tissue was higher in the obese group. Notable differences were found among the groups for both 2D speckle tracking derived and 3D LV GLS, RV GLS, RV free-wall LS (analysis of variance ANOVA, p<0.05) showing lower deformation in obese subjects. LV torsion was found to be significantly higher (ANOVA, p<0.05) for the obese group. CONCLUSIONObesity causes subclinical dysfunction of LV and RV in healthy obese subjects in early adulthood. Risk stratification should be performed by considering possible mentioned impact of obesity on myocardial functions.
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