Background: Breast cancer is the most prevalent malignancy in women and a leading cause of mortality. Accurate assessment of axillary lymph node metastasis (LNM) is critical for breast cancer management. Exploring non-invasive methods such as radiomics for the detection of LNM is highly important. Methods: We systematically searched PubMed, Embase, Scopus, Web of Science and google scholar until 11 March 2024. To assess the risk of bias and quality of studies, we utilized the quality assessment of diagnostic accuracy studies (QUADAS) tool as well as the radiomics quality score (RQS). Area under the curve (AUC), sensitivity, specificity and accuracy were determined for each study to evaluate the diagnostic accuracy of radiomics in magnetic resonance imaging (MRI) for detecting LNM in patients with breast cancer. Results: This meta-analysis of 20 studies (5072 patients) demonstrated an overall AUC of 0.83 (95% confidence interval (CI): 0.80–0.86). Subgroup analysis revealed a trend toward higher specificity when radiomics was combined with clinical factors (0.83) compared to radiomics alone (0.79). Sensitivity analysis confirmed the robustness of the findings and publication bias was not evident. The radiomics models increased the likelihood of a positive LNM outcome from 37% to 73.2% when initial probability was positive and decreased the likelihood to 8% when initial probability was negative, highlighting their potential clinical utility. Conclusion: Radiomics as a non-invasive method demonstrates strong potential for detecting LNM in breast cancer, offering clinical promise. However, further standardization and validation are needed in future studies.

We decided to evaluate the effect of treatment of diabetic foot ulcers in improving heart function by strain echocardiography than conventional transthoracic echocardiography. This prospective cross-sectional study included patients with diabetic foot ulcer (DFU). Conventional and two-dimensional strain echocardiography performed before and after three months diabetic foot treatment. Then, we compared the echocardiographic parameters including left ventricular ejection fraction (LV-EF), left ventricular global longitudinal strain (LV-GLS). Multivariate and univariate logistic regression analysis were performed to find which variable was mainly associated with LV-GLS changes. 62 patients with DFU were conducted. After echocardiography, all patients underwent surgical or non-surgical treatments. Three months after the treatment, LV-EF was not significantly different with its’ primary values (P = 0.250), but LV-GLS became significantly different (P<0.05). In the multivariate logistic regression analysis, with the increase in the grade of ulcer, LV-GLS improved by 6.3 times. Not only the treatment of DFU helps to control adverse outcomes like infection, limb loss and morbidity but also it enhances cardiac function. Of note, strain echocardiography found to be a better indicator of myocardial dysfunction than LV-EF. These findings make a strong reason for the routine assessment of cardiac function in patients with DFU.

Diastolic dysfunction (DD) is a risk factor for cardiovascular events in patients undergoing non-cardiac surgeries. Investigators aimed to assess the effect of physical activity level on the diastolic function of the left ventricle (LV) in patients attending the preoperative visit. This analytic cross-sectional study was conducted on 228 patients referred to Poursina hospital from November 2021 to March 2022. To define the physical activity level, we used the short form of the International Physical Activity Questionnaire (IPAQ). We categorized patients into inactive, minimally active, and health-enhancing physical activity groups. We also divided participants into three groups based on their daily sitting time. Also, echocardiographic parameters were calculated. The diastolic function of LV was evaluated, and its grading was defined from mild (grade1) to severe (grade 3). Results showed that patients with DD had significantly higher age and lower levels of education (P < 0.001 and P = 0.005, respectively). After assessing echocardiographic parameters, we found that E/e’, TR Velocity, left atrial volume index, and pulmonary artery pressure had a statistically significant inverse relationship with physical activity level (P < 0.001 for all). Comparing physical activity level of subgroups showed that in HEPA (health-enhancing physical activity), the chance of developing grade 2 or 3 DD was reduced by 97% compared to the inactive group (OR = 0.03, P < 0.001). Still, there was no significant difference between the inactive and minimally active groups (P = 0.223). This study showed an inverse relationship between physical activity level and DD of the LV in a sample of 228 individuals attending the Anesthesia Clinic, independent of potentially confounding variables.Therefore, due to lower rate of DD in patients who are physically active, we can expect lower occurrence rate of cardiovascular events during surgery.

Nodular fasciitis rarely arises from the masseter muscle and is frequently misdiagnosed as soft tissue sarcoma. A 43-year-old male presented with a rapidly enlarging, painless swelling below the right mandibular angle over 2 months. Clinical examination revealed a firm, mobile mass without skin fixation or lymphadenopathy. Ultrasound and magnetic resonance imaging were performed, followed by fine-needle aspiration cytology and excisional biopsy. Ultrasound demonstrated a well-defined, hypoechoic lobulated lesion (23 × 13 × 8 mm) within the superficial masseter, showing mild internal vascularity and no bone involvement. Magnetic resonance imaging revealed an iso- to slightly hypointense T1 signal, hyperintense T2/ short tau inversion recovery signal, and homogeneous postcontrast enhancement with smooth margins, features suggestive of a benign myofibroblastic lesion. Excisional biopsy confirmed the diagnosis of nodular fasciitis. This case indicates that masseteric nodular fasciitis, a rare benign lesion, may present with imaging features of small size, smooth margins, homogeneous enhancement, and mild vascularity in the context of trauma history. Recognition of this self-limited myofibroblastic proliferation can prevent unnecessary radical surgery and guide conservative management.