Background: The potential benefit of neoadjuvant chemotherapy (NAC) in colon cancer is under evaluation. There is a need to improve preoperative non-invasive diagnostics using techniques that provide more accurate staging information in assessing patient eligibility for NAC. Purpose: To investigate the link between the tumor grade (pathohistological confirmed) and the N status (corresponding to lymph node involvement) with apparent diffusion coefficient (ADC) values. Material and Methods: A total of 17 patients planned for surgical resection had a biopsy confirming colon carcinoma and participated in the study. Abdominal magnetic resonance imaging with diffusion-weighted imaging/ADC sequence was recorded before surgery. The tumor and all visible lymph nodes were manually delineated directly on a grayscale ADC map for every single slice and detected to access the total tumor and summarized lymph node volume. The mean ADC value was further calculated for the mean tumor and mean lymph node values. Results: Low-grade tumors had a mean ADC equivalent to 1225 ± 170×10⁻⁶ mm²/s, and the coefficient of high-grade tumors was 1444 ± 69×10⁻⁶ mm²/s. The group of patients with positive lymph nodes in operative tissue samples (N+) exhibited lower mean ADC values (1023 ± 142×10⁻⁶ mm²/s) as opposed to the group without metastatic lymph nodes (N–) with ADC values of 1260 ± 231×10⁻⁶ mm²/s. Conclusion: The mean whole-tumor ADC is associated with the histological tumor grade, and the mean ADC value of whole-volume abdominal lymph nodes could assume real nodal infiltration.

Background and Objectives: Perforated peptic ulcers are a common surgical emergency and rank among the leading causes of acute peritonitis worldwide. Previous studies have suggested a seasonal pattern in the occurrence of symptomatic perforated peptic ulcers. With the advancement of modern medicine, including the widespread use of proton pump inhibitors, and the effects of climate change, this study aimed to assess potential seasonal variations in the incidence of peptic ulcer perforation in our region. Methods: This retrospective analysis included 104 adult patients (mean age: 61.5 ± 14.7 years) who underwent surgical treatment for peptic ulcer perforation between January 2021 and April 2024. Patients were analyzed by gender, age, risk factors (smoking and alcohol consumption), the location of the perforation (gastric or duodenal), and discharge outcome (survived or deceased). Additionally, cases were categorized by the month and season of the ulcer perforation. Results: Among the 104 patients (mean age 61.5 ± 14.7 years), 68 (65.4%) were male. Gastric and duodenal perforations were nearly equally observed (51% vs. 49%). A statistically significant difference in overall perforation rates by gender was observed (p = 0.009), though not between ulcer sites (p = 0.628 and p = 0.739). The highest number of perforations occurred in July (n = 12), while the lowest occurred in November (n = 4); however, no significant variation was found by month (p = 0.916) or season (p = 0.891), despite a predominance in spring. Comorbidities were present in 60% of patients. Smoking (33.6%) and alcohol use (22.1%) were common. Alcohol abuse was noted in 22.1% of patients and was significantly associated with both gastric (p < 0.001) and duodenal (p < 0.001) perforations, though not with the overall incidence (p = 0.284). Smoking, reported in 33.6% of patients, showed no significant association with the perforation site or overall incidence (p = 0.946). The combination of smoking and alcohol use favored gastric perforations, but without statistical significance (p = 0.157). Conclusions: Alcohol consumption appeared to increase the risk of ulcer perforation, while smoking did not demonstrate a statistically significant association. Although spring exhibited the highest observed incidence of peptic ulcer perforation, seasonal variation did not show a statistically significant difference overall.

Introduction: Complications of COVID-19 infection have been greatly investigated. The most recent studies found strong association of COVID-19 pneumonia with thromboembolism. The aim of research was to describe clinical and computed tomography pulmonary angiograms (CTPA) characteristics of COVID-19 related pulmonary artery thromboembolism (PE). Methods: All consecutive CTPA with positive PE in COVID-19 patients from University Hospital Split, from March 23, 2020 to January 31, 2021 were analyzed. Baseline data were collected from patient’s electronic records. CTPA scan analysis identified PE anatomical location (i.e., main, lobar, segmental, or subsegmental). Results: A total number of 78 positive CTPA in COVID-19 patients was mainly in elderly with several co-morbidities, high D-dimer levels, at median of 14 days. CTPAs showed involvement of the entire pulmonary artery tree, mainly of the small-to medium diameter pulmonary artery branches, unilaterally (n = 31, 39,74%), and bilaterally (n = 33, 42.31%). The large-diameter branches were the most rarely affected as a single location (n = 14, 17.95%). Conclusion: PE occurred in predominantly elderly people, having several comorbidities, and high D-dimer levels. Embolic involvement of pulmonary branches of all sizes were found, the most frequent of small to medium diameter branches. Further investigation is needed to better understand mechanisms and course of the COVID-19 related PE.

Objectives: This study aimed to investigate whether the apparent diffusion coefficient (ADC) maps values of breast lesions presenting as non-mass enhancement (NME) on MRI could predict benign or malignant pathohistological findings. Materials and Methods: This retrospective single-center study included 136 female patients with NME and corresponding ultrasound correlate and a subsequent ultrasound-guided core needle biopsy. The patients were subdivided into benign or malignant subgroups based on pathology reports, which served as the gold standard. Blinded to the pathological results, two radiologists independently measured the ADC values of the depicted NME using punctate, 10 mm and whole tumor regions of interest (ROIs) wherever applicable. The mean of all measurements was also analyzed and compared with the pathologic subdivision. Results: The sensitivity of whole tumor ROI in detecting benign NME is 91% compared to 74% for 10 mm ROI and 78% for punctate ROI. No significant differences in ADC values were observed when comparing fatty breast tissue and dense breast tissue. Conclusions: There were differences in ADC values between benign and malignant findings using all types of measurements, where the whole tumor ROI was the most sensitive.

Different aspects of the coronavirus disease 2019 (COVID-19) infection have been widely investigated since the onset of a pandemic in December 2019. Several studies investigated differences in disease development and presentation compared to patient characteristics. In this paper we present an overview of the first COVID-19 pandemic wave in Dalmatia, Croatia with specifics related to patients’ age. Demographic, clinical and radiological data from hospitalized COVID-19 positive patients in the Clinical Hospital Split over a three-month period were collected and analyzed. Subgrouping and additional analysis were performed: Octogenarians vs Non-octogenarians, and senior residence vs nonsenior residence. 160 COVID-19 positive patients were enrolled. Of those, 61% were females. Median age was 78. More than a half of all patients were senior residents. No differences in final outcome were observed comparing specific medicament treatment. Among Octogenarians group, there were more asymptomatic cases, and higher mortality rate. Some differences in radiological presentation were also observed. Senior COVID-19 positive patients are more often asymptomatic but with higher mortality rates. More attention should be paid to early detection on COVID-19 infection in the senior population.