The study aimed to describe clinical characteristics and outcomes of pregnant women with COVID-19 undergoing cesarean section, and evaluated the association of blood values at admission with severe ...COVID-19 disease in this group of patients.
We retrospectively analyzed the clinical data of 110 patients infected with COVID-19 who underwent cesarean section at Adana City Education and Research Hospital in Turkey. The COVID-19 severity of the patients was classified as either severe or nonsevere disease according to World Health Organization of COVID-19 clinical management guidance. We compared blood values, clinical characteristics, and outcomes between severe and nonsevere patients. Receiver operating characteristics (ROC) curves analyses and area under the ROC curve (AUC) value was calculated to evaluate the predictive value of blood parameters on the COVID-19 severity.
Of the 110 women, 12 were severe cases. Severe patients had higher ferritin, neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), and procalcitonin levels on admission (p < 0.05). The ROC analysis demonstrated AUC of NLR, LDH, AST, ALT, ferritin, and procalcitonin was 0.757, 0.856, 0.840, 0.771, 0.821, and 0.698, respectively. The LDH had a maximum specificity (90.8%), with the cutoff value of 365. The O-blood group was more likely to have severe illness than the non-O-blood group (relative risk: 3.6; 95% confidence interval; 1.2-10.4).
This study shows that LDH values at admission are an early and powerful predictor of severe infection for pregnant women with COVID-19 who will undergo a cesarean section.
Purpose
Pancreas contour variations can sometimes be misdiagnosed as mass lesions. This study aimed to evaluate normal pancreatic contour morphology, variations, frequency and the development of the ...uncinate process.
Methods
Out of 1183 consecutive computed tomography images taken in our hospital for various reasons (e.g. malignity, donor), 899 suitable images were included in the study. The following variations were identified: globular, elongated or globular–elongated contours of the pancreas head, protrusions of the body–tail surfaces and globular, lobular, globular–lobular, tapered and bifid contours of the tail. Hypoplasia and aplasia of the uncinate process were identified. All images were evaluated retrospectively by two radiologists.
Results
Of the 899 patients, 504 (56.1%) were males. The mean age of the patients was 53.9 ± 14.7 (range 18–89). Hypoplasia of the uncinate process was found in 72 (8%) patients; aplasia was seen in 11 (1.2%) patients. Thirty-one (3.5%) of the pancreatic head variations were globular, 49 (5.4%) elongated and three (0.3%) elongated–globular. In patients with pancreatic uncinate process developmental anomaly, contour variations were also detected in the head of the pancreas. The pancreatic body–tail showed protrusions anteriorly in 76 (8%) patients and posteriorly in 11 (1.2%) patients. Seventy-two (8%) of the pancreatic tail variations were globular, 39 (4.4%) were globular–lobular, 18 (2%) were tapered and 17 (1.8%) were bifid.
Conclusion
Patients with pancreatic uncinate process developmental anomaly also have contour variations in the head of the pancreas. Pancreatic uncinate process developmental anomaly was seen in 9.2%. Pancreatic tail contour variation was 16.2%. The pancreatic body–tail showed protrusion in 9.2% of patients.
Aim of this study is to categorize stones between 10 and 20 mm according to stone diameter or volume and compare mini percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) ...outcomes. Files of 515 patients who underwent surgery for kidney stones with sizes 10–20 mm were reviewed. Patients were divided into RIRS or mPNL groups. An attempt was made to find the diameter and volume threshold values above which the success of the operation, complication rates and the number of auxiliary treatments deteriorated. Subgroup analysis was performed below and above the threshold value to reveal the optimal treatment methods. RIRS complications increased with volumes above 1064 mm
3
, number of auxiliary interventions increased with volumes above 1256 mm
3
, and success of the operation decreased with volumes above 1416 mm
3
. A subgroup analysis under and over 1064 mm
3
was performed in RIRS group. Complication and auxiliary treatment rates were higher, operative success was lower in patients with a stone volume greater than 1064 mm
3
. In patients who underwent RIRS, for every 1000 mm
3
increase in stone volume success of the operation decreased by 2.1 times, while the probability of auxiliary treatment increased by 2.8 times. In patients with kidney stones between 10 and 20 mm, it is more meaningful to use volume instead of diameter to determine the success rate. When mPNL is used instead of RIRS for volumes greater than 1064 mm
3
, the success rate will be higher, complication rate will be similar, and the need for auxiliary treatment will be lower.
Purpose
This study was to investigate the effect of mesorectal fat tissue volume (MRV) on the pathological response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal ...cancer.
Methods
88 patients who had been diagnosed with locally advanced rectal cancer between January 2017 and June 2020 were reviewed retrospectively. The total abdominal, subcutaneous, visceral, and mesorectal fatty tissue components were measured semiquantitatively by two radiologists using computed tomography (CT)-based findings. The patients were divided into two groups as those with and without a pathological response to nCRT. The relationship of MRV with the other fat tissue components of the body was also evaluated.
Results
We performed a retrospective analysis of 88 patients (mean age 62.7 years range, 33–90 years; 31 males and 57 females). A positive response to nCRT was present in 47 patients. There were 59 patients with stage 3 disease. 46 patients demonstrated lymph node involvement
.
The mean MRV was 69.6 ± 31.0 ml in no-response group and 105.8 ± 47.5 ml in response-positive patients (
p
< 0.05). MRV showed the highest correlation with visceral fat volume (VFV). There was a negative correlation between the MRV and the N stage. A cut-off value of ≥ 69.4 for MRV predicted the repsonse to nCRT, with 82.9% sensitivity and 58.5% specificity AUC: 0.757 (0.653–0.842),
p
< 0.001 in receiver operating characteristic (ROC) curve analysis
Conclusions
MRV can be used as a novel parameter in predicting of pathological response to nCRT in locally advanced rectal cancer patients.
Purpose
To determine the widths of fallopian canal segments (labyrinthine segment, geniculate ganglion, tympanic segment mastoid segment and stylomastoid foramen), in two nations with different ...ethnic origins, and to analyze the differences in between.
Methods
We retrospectively analyzed temporal computerized tomographies of 102 individuals including 38 Turks and 64 Syrians. The widths of right and left labyrinthine (LS), tympanic (TS), mastoid (MS), geniculate ganglion (GG) and stylomastoid foramen (SF) segments of the fallopian canal were measured.
Results
The narrowest segment was LS (right: 1.04 ± 0.23 mm, left: 1.03 ± 0.22 mm) and the widest segment was SF (right: 1.82 ± 0.41 mm, left: 1.85 ± 0.35 mm). From the widest to the narrowest, the widths of the FC segments were sorted as SF > GG > MS > TS > LS. The widths of the fallopian canal segments were similar between right and left sides, and between males and females (
p
> 0.05). Our results indicated that both right and left GG were significantly wider in Turks (
p
< 0.001 for both), however right LS (
p
< 0.001) and left TS (
p
= 0.005) were significantly wider in Syrian refugees. Two groups did not show any differences for the widths of other FC segments (
p
> 0.05).
Conclusions
Nations of different ethnic origins may have differences concerning the widths of some segments of the fallopian canal. Further studies with a larger sample size including clinical data of the patients are needed to clarify our findings, and to determine whether these differences have any clinical implications.
The aim of our study was to determine the anatomical variations detected on computed tomography radiological imaging of the paranasal sinus between citizens and refugees patient groups and to reveal ...the differences between the two patient groups
.
In this study, the data from the files of 38 Turkish Citizens (Group 1), 41 Syrian Refugees (Group 2), a total of 79 patients who were admitted to the ENT Clinic of Adana City Training and Research Hospital due to rhinological complaints between 01.01.2019 and 01.01.2020 and had paranasal sinus tomography, were analyzed retrospectively
.
Due to the Syrian Civil War that started in 2011, more than 10 million Syrian have left their countries and immigrated to neighboring countries as refugees. The paranasal sinus area has a wide variety of variations. Congenital anomalies and normal anatomical variations in this area are important, although rarely, as they may have pathological consequences or may be a source of difficulty during surgery. In the study, 38 of 79 patients were in Group 1 (48.1%) and 41 were in Group 2 (51.9%). Of the patients, 30 were female (38%) and 49 were male (62%). The ages of the patients ranged from 9 to 78 years, with a mean age of 32.52 years. In our study, we could not find a statistically significant difference between Turkish Citizens and Syrian refugees in terms of anatomical variations detected on paranasal radiological imaging. We consider the number of patients in our study as a limitation of our study and we think that it is important to conduct studies with larger populations
PURPOSE We aimed to evaluate the use of the COVID-19 reporting and data system (CO-RADS) among radiologists and the diagnostic performance of this system. METHODS Four radiologists retrospectively ...evaluated the chest CT examinations of 178 patients. The study included 143 patients with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results and 35 patients whose RT-PCR tests were negative but whose clinical and/or radiological findings were consistent with COVID-19. Fleiss' kappa (kappa) values were calculated, and individual observers' scores were compared. To investigate diagnostic efficiency, receiver operating characteristic (ROC) curves were calculated for each interpreter. RESULTS The interpreters were in full agreement on 574 of 712 (80.6%) evaluations. The common Fleiss' kappa value of all the radiologists combined was 0.712 (95% confidence interval CI 0.692-0.769). A reliable prediction on the basis of RT-PCR and clinical findings indicated the mean area under the curve (AUC) of Fleiss' kappa value as 0.89 (95% CI 0.708-0.990). General interpreter agreement was found to range from moderate to good. CONCLUSION The interpreter agreement for CO-RADS categories 1 and 5 was reasonably good. We conclude that this scoring system will make a valuable contribution to efforts in COVID-19 diagnosis. CORADS can also be of significant value for the diagnosis and treatment of the disease in cases with false-negative PCR results.
Introduction: The world population is getting older with each passing year.Thyroid cancer is the most common endocrinological cancer and its incidence is increasing in all populations. Although the ...increase in prevalence has been attributed more to the increased use of imaging methods and to the higher sensitivity of ultrasonography (USG) by some authorities, there are also studies suggesting a real increase.In our study, it was aimed to examine the USG and fine needle aspiration cytology (FNAC) results of thyroid nodules in the geriatric age group and to discuss them in the light of the literature.
Methods: Files of 129 geriatric patients with thyroid nodules detected in the University Of Health Sciences Adana City Training and Research Hospital between 2018 and 2020 were retrospectively analyzed.The USG characteristics of the patients were categorized by scoring according to the ACR TIRADS system. FNAC diagnoses were grouped according to the Bethesda classification.
Results: According to the ACR TIRADS grading, 4 patients (3.1%) were benign, 58 patients (45%) were not suspicious, 38 patients (29.5%) were mildly suspicious, 25 patients (19.4%) were moderately suspicious, and 4 patients (3.1%) were highly suspicious.In our study, although USG provided very valuable information in the approach to thyroid nodules, no relationship was found between TIRADS in the geriatric age group and FNAC results in our study (p = 0.117).
Conclusion: We think that the approach to thyroid nodules in geriatric patients requires closer follow-up not only with USG data but also with clinical and history-based findings.
The present study aims to evaluate whether perfusion parameters in prostate magnetic resonance imaging (MRI),
Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed ...tomography (CT), prostate-specific antigen (PSA), and PSA density can be used to predict the lesion grade in patients with prostate cancer (PCa).
The study included a total of 137 PCa cases in which 12-quadrant transrectal ultrasound-guided prostate biopsy (TRUSBx) was performed, the Gleason score (GS) was determined, and pre-biopsy multiparametric prostate MRI and
Ga-PSMA PET/CT examinations were undertaken. The patient population was evaluated in three groups according to the GS: (1) low risk; (2) intermediate risk; (3) high risk. The PSA, PSA density, pre-TRUSBx
Ga-PSMA PET/CT maximum standardized uptake value (SUVmax), perfusion MRI parameters maximum enhancement, maximum relative enhancement, T0 (s), time to peak (s), wash-in rate (s
), and wash-out rate (s
) were retrospectively evaluated.
There was no significant difference between the three groups in relation to the PSA, PSA density, and
Ga-PSMA PET/CT SUV
(
> 0.05). However, the values of maximum enhancement, maximum relative enhancement (%), T0 (s), time to peak (s), wash-in rate (s
), and wash-out rate (s
) significantly differed among the groups. A moderate positive correlation was found among the prostate volume, PSA (r = 0.490), and
Ga-PSMA SUV
(r = 0.322) in the patients. The wash-out rate (s
) and wash-in rate (s
) had the best diagnostic test performance (area under the curve: 89.1% and 78.4%, respectively).
No significant correlation was found between the
Ga-PSMA PET/CT SUV
and the GS. The wash-out rate was more successful in estimating the pretreatment GS than the
Ga-PSMA PET/CT SUV
.
Purpose: This study aimed to evaluate the predictability of survival in patients with glioblastoma using a machine learning (ML) model developed with tissue analysis features obtained through ...preoperative post-contrast T1-weighted images(T1WI).
Materials and Methods: The radiomic features of tumors were obtained from postcontrast T1WI of 60 glioblastoma patients. Radiomic properties, density, shape, and textural properties obtained from six matrices were included in the analysis. The patients' three- and six-month survival rates were recorded. Five different ML algorithms were applied to create predictive models random forest, neural network, linear discriminant analysis(LDA), stochastic gradient descent (SGD), and support vector machine(SMV).
Results: The mean survival time of the patients was 295.4 days, and the median value was 211.5 (17-1357) days. Among the models developed for three- and six-month survival prediction, the highest success was obtained from the LDA algorithm, in which the AUC values were calculated as 0.88 and 0.78, respectively.
Conclusion: Using ML techniques, the success of predicting imaging-based patient survival was very high. With the development and widespread adoption of these techniques, ML models will be useful in deciding on treatment according to survival prediction in glioblastoma.
Amaç: Bu çalışma ameliyat öncesi kontrastlı T1 ağırlıklı görüntülerden(T1AG) elde edilen doku analizi(radyomiks) özellikleriyle geliştirilen makine öğrenimi(MÖ) modeli kullanılarak glioblastomlu hastalarda sağkalımın öngörülebilirliğini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Tümörlerin radyomiks özellikleri 60 glioblastoma hastasının kontrastlı T1AG’den elde edildi. Altı matristen elde edilen radyomik özellikler, yoğunluk, şekil ve dokusal özellikler analize dahil edilmiştir. Hastaların üç ve altı aylık sağkalım oranları kaydedildi. Tahmine dayalı modeller random forest, neural network, linear discriminant analysis(LDA), stochastic gradient descent (SGD), support vector machine(SMV) oluşturmak için beş farklı MÖ algoritması uygulandı.
Bulgular: Hastaların ortalama sağkalım süresi 295,4 gün, medyan değeri 211,5 (17-1357) gündü. Üç ve altı aylık sağkalım tahmini için geliştirilen modellerden en yüksek başarı, EAA değerlerinin sırasıyla 0,88 ve 0,78 olarak hesaplandığı LDA algoritmasından elde edilmiştir.
Sonuç: MÖ tekniklerini kullanarak, görüntülemeye dayalı hasta sağkalımını tahmin etme başarısı çok yüksekti. Bu tekniklerin gelişmesi ve yaygınlaşması ile MÖ modelleri, glioblastomda sağkalım tahminine göre tedaviye karar vermede faydalı olacaktır.
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