Background: The pulmonary artery area (PAA) is a valuable non-invasive method for the diagnosis of pulmonary hypertension. Purpose: To compare the change in PAA in patients with COVID-19 with the computed tomography (CT) severity index using follow-up imaging. Material and Methods: A total of 81 patients who were followed up and underwent CT assessment more than once at our hospital‘s pandemic department were evaluated retrospectively. Patients with progression were separated into three groups: progression ranging from mild-to-mild infiltration (Group A, CT severity index of 0–2); progression from mild to severe infiltration (Group B, CT severity index of 0-2 to 3–5); and progression from severe-to-severe infiltration (Group C, CT severity index of 3–5). The PAAs were calculated separately. Results: The mean age was 56 ± 12 years. In terms of those patients showing progression in the CT images, the number of patients in Groups A, B, and C was 29, 40, and 12 in the right lung; 32, 45, and 4 in the left lung; 23, 45, and 13 on both lungs, respectively. There was no significant difference between the main, right, and left PAAs in Group A ( P > 0.05). In Group B, there were significant increases in the areas of the main, right, and left PAAs ( P < 0.05). There were also significant increases in the areas of the right and main pulmonary arteries in Group C ( P < 0.05). Conclusion: PAAs increase as disease involvement advances in cases with COVID-19 pneumonia, which is thought to be correlated with progression.
Bankart lesions accompany superior labrum anteroposterior (SLAP) lesions; these are called SLAP type 5. To compare SLAP type 5 lesions using routine magnetic resonance arthrography (MRA) and thin-slice oblique sagittal proton density (PDW) sequences and correlation operation results. In total, 181 patients were admitted with shoulder instability. The study was completed with 44 patients. The presence or absence of isolated Bankart and SLAP type 5 lesions in routine MRA and PDW oblique sagittal images were evaluated separately. Absence of rupture scored 0 points, suspected ruptures scored 1 point, and apparent ruptures scored 2 points. The two scores were compared with the shoulder arthroscopy findings. According to the findings in the shoulder arthroscopy, 40 patients had Bankart lesions and 17 patients had accompanying SLAP type 5 lesions. To detect a Bankart lesion, there was no significant difference between routine MRA sequences and PDW oblique sagittal images (P = 0.061). Routine MRA sensitivity was 95%, specificity 25%, positive predictive value (PPV) 92%, negative predictive value (NPV) 33%, while for PDW oblique sagittal images, sensitivity was 75%, specificity 100%, PPV 100%, and NPV 28.5%. In 8/17 type 5 SLAP lesions, routine MRA detected sensitivity 47%, specificity 92.6%, PPV 80%, and NPV 73.5%; in 14/17 SLAP type 5 lesions, PDW oblique sagittal images detected sensitivity 82%, specificity 100%, PPV 100%, and NPV 90% (P = 0.015). The PDW oblique sagittal images may play a significant role in assessing the anterior and superior extent of the tears.
Background: Percutaneous biliary drainage is a frequently used method to provide biliary decompression in patients with biliary obstruction. Purpose: To investigate the between drainage type and infection risk in patients treated with internal-external and external biliary drainage catheterization for malignant biliary obstruction. Material and Methods: A total of 410 patients with malignant biliary obstruction who underwent internal-external or external biliary drainage catheterization between January 2012 and October 2016 were retrospectively evaluated. We investigated the correlation between percutaneous biliary drainage technique and infection frequency by evaluating patients with clinical findings, bile and blood cultures, complete blood counts, and blood biochemistry. Results: There was no statistically significant difference between the selected patient groups (internal-external or external biliary drainage catheter placed) in terms of age, sex, primary diagnosis, receiving chemotherapy, catheter sizes, and outpatient-patient status. After catheterization, catheter-related infection was observed in 49 of 216 (22.7%) patients with internal-external and 18 of 127 (14.2%) patients with external biliary drainage catheters, according to the defined criteria. There was no difference in infection rate after the biliary drainage in the two groups ( P > 0.05). There was also no difference concerning frequently proliferating microorganisms in bile cultures. Conclusion: Internal-external biliary drainage catheter placement does not bring an additional infection risk for uninfected cholestatic patients whose obstruction could be passed easily in the initial drainage.
Background: Cancellations of surgeries for elective cases and late admissions of symptomatic cases during the pandemic period might have increased the number of cases of acute cholecystitis and its complications. Purpose: To compare the severity of acute cholecystitis and complication rates during the pandemic and pre-pandemic periods. Material and Methods: We evaluated the computed tomography (CT) findings observed for the diagnosis of complications for both acute simple and acute complicated cholecystitis during both the pandemic and pre-pandemic periods. Patients admitted to the hospital between March 2020 and December 2020 made up the study group and the corresponding appropriate patients from one year earlier were studied as the control group. In addition to the CT findings, clinical and laboratory findings, co-morbidities such as diabetes, as well as the admission time to hospital from the onset of the initial symptoms to hospital admission were also evaluated. Results: A total of 88 patients were evaluated (54 in the study group, 34 in the control group; mean age = 64.3 ± 16.3 years). The male-to-female ratio was 51/37. The number of patients diagnosed with complicated cholecystitis were significantly higher in the study group ( P = 0.03). Murphy finding and diabetes status were similar between the two groups ( P = 0.086 and P = 0.308, respectively). Admission time to the hospital was significantly different for study and control groups in simple cholecystitis patients ( P = 0.045); with no significant difference in cases of complicated cholecystitis ( P = 0.499). Conclusion: Our study reveals the course of acute cholecystitis during the pandemic period was much more serious with higher complications.
9 June 2023 in Uludağ Üniversitesi Tıp Fakültesi Dergisi
Bu çalışmada, Multiparametrik Manyetik Rezonans (mp-MR) tetkikinde PIRADS 3 (Prostat Görüntüleme Raporlama ve Bilgi Sistemi) ve üzeri lezyonu bulunan hastalarda MR- Transrektal Ultrasonografi (MR-TRUS) eşliğinde füzyon biyopsi ve kognitif Füzyon (KF) biyopsi tekniklerinin prostat kanseri saptamadaki etkinliklerinin karşılaştırılması amaçlanmıştır. Kliniğimizde 2017-2022 yılları arasında biyopsi öncesi yapılmış mp-MR tetkiklerinde PIRADS 3 ve üzeri lezyonu bulunan, PSA değeri 2-20 ng/ml arasında olan, daha önce hiç prostat biyopsisi yapılmamış ve mp-MR tetkiki sonrası ilk 6 ay içerisinde 48 MR-TRUS, 48 KF füzyon biyopsisi yapılmış 96 hasta seçildi. Hasta yaşı, PSA değeri, prostat volümü, lezyonların boyutu ve PIRADS skoru gibi parametreler değerlendirildi. Gruplar arasında demografik verilerde, PSA değerleri, prostat volümleri ve lezyonların boyut ve PIRADS skorlarında anlamlı farklılık saptanmadı (p>0.05). Kognitif füzyon yapılan grupta herhangi bir lokalizasyonda kanser yakalama oranı %41,7 (20/48 hasta), MR-TRUS füzyon biyopsi yapılan grupta %39,6 (19/48 hasta) bulundu. İki grup arasında istatistiksel olarak anlamlı farklılık saptanmadı (p=0,835). Hedefli biyopsi sonuçlarında ise kanser saptama oranları KF grubunda %85 (17/20 hasta), MR-TRUS grubunda %73,7 (14/19 hasta) bulundu. Bu iki grup arasında da anlamlı farklılık izlenmedi (p=0,518). Sonuç olarak, kanser yakalama başarısının benzer olması, uygulamasının daha kolay ve maliyetinin daha düşük olması nedeniyle KF biyopsi tekniği MR-füzyon biyopsisine tercih edilebilir.