OBJECTIVE: The aim of this study was to investigate the frequency of aortic arch anomaly in COVID-19 patients and to determine whether it will be included in the risk classification. METHODS: The study was retrospectively-conducted in a third-level hospital by scanning the contrast-enhanced thoracic computed tomography and thoracic computed tomography angiography examinations of patients who received PC R (+), hospitalization, and known COVID pneumonia between March 2020 and July 2021. The study consists of 88 cases and 88 control groups. RESULTS: The study found that the frequency of aortic arch anomaly was higher in patients with COVID-19 pneumonia and in male patients with bovine-type anomaly. CONCLUSIONS: The higher prevalence of bovine arch anomaly in COVID patients may be considered a risk factor for COVID-19 in individuals with this type of vascular anomaly.

Background: Core decompression (CD) combined with bone marrow aspirate concentrate (BMAC) is used as a joint-preserving treatment for osteonecrosis of the femoral head (ONFH), but factors associated with treatment failure remain unclear. This study evaluated factors associated with total hip arthroplasty (THA) conversion and structural progression after CD with BMAC. Methods: This small retrospective cohort study included 56 patients (56 hips) treated with CD and BMAC for ONFH between August 2020 and December 2025. Corticosteroid exposure, preoperative Association Research Circulation Osseous (ARCO) stage, and clinical outcomes were evaluated. The primary outcome was THA conversion; secondary outcomes included radiographic progression and changes in clinical scores. Multivariable logistic regression was used to evaluate associations with THA conversion and progression to ARCO stage IV. Kaplan–Meier analysis was used to estimate THA-free survival. Median observation time from CD+BMAC to THA or the final native-hip assessment on 1 January 2026 was 28.5 months (IQR, 9.5–34.25). Results: Seventeen hips (30.4%) underwent THA. THA conversion increased from 15.4% in hips without corticosteroid exposure to 83.3% in those exposed for >6 months (p = 0.007). Increasing corticosteroid exposure duration was associated with THA conversion in the two-variable model (aOR, 2.48; 95% CI, 1.31–4.67; p = 0.005). The association between ARCO stage III and THA conversion was not statistically significant; this does not exclude an association. Progression to ARCO stage IV occurred in 92.9% of stage III versus 28.6% of stage II hips (p < 0.001). Both ARCO stage III (aOR, 38.03; 95% CI, 3.90–371.17; p = 0.002) and increasing corticosteroid exposure (aOR, 2.58; 95% CI, 1.20–5.57; p = 0.016) were associated with stage IV progression in the two-variable model. Despite significant clinical improvement, 71.4% of hips showed radiographic progression. Kaplan–Meier THA-free survival was 79.1% at 12 months, 68.3% at 24 months, and 64.3% at 36 months; median THA-free survival was not reached. At the final native-hip assessment, patients who subsequently underwent THA showed significantly smaller improvements in VAS, HHS, and WOMAC scores than those who remained free from arthroplasty (all p < 0.001). Conclusions: Corticosteroid exposure duration and preoperative ARCO stage showed associations with clinical and radiographic outcomes after CD+BMAC. Longer corticosteroid exposure was associated with THA conversion and radiographic progression, whereas advanced ARCO stage was associated with radiographic progression. These associations require validation in prospective studies.

Considerable interindividual variability exists in the spread and duration of spinal anesthesia despite standardized anesthetic techniques. Lumbosacral cer

Background and Objectives: Magnetic resonance imaging (MRI) is the gold standard for rectal cancer staging; however, its reliability after neoadjuvant therapy (NAT) remains controversial due to treatment-induced tissue changes. This study aimed to compare preoperative MRI findings with postoperative pathologic results in rectal cancer patients following NAT and to assess MRI reliability across clinical subgroups. Materials and Methods: This single-center retrospective study included 47 adult patients with locally advanced rectal adenocarcinoma who received NAT followed by elective rectal resection, with preoperative pelvic MRI and postoperative pathology results. Clinical features, MRI (T stage, N stage, and circumferential resection margin [CRM]), and pathologic staging were recorded. The endpoints were defined as concordance (via kappa coefficients) and predictive performance (via ROC analysis). Results: Among 47 patients (mean age 63.5 ± 9.4 years; 80.9% male), MRI demonstrated slight concordance with pathology for the T stage (kappa = 0.178, p = 0.028) and moderate concordance with the N stage (kappa = 0.489, p < 0.001), but not for CRM (p = 0.154). Subgroup analyses revealed significant concordance for N stage across most subgroups, with lower rectal tumors showing significant agreement for all three parameters. ROC analysis demonstrated significant predictive value for the N stage (AUC = 0.776, p = 0.002) with 88.6% specificity, while the T stage and CRM showed non-significant discriminatory performance. Conclusions: Post-NAT MRI demonstrates moderate reliability relative to pathology, particularly for N staging, and may have even better utility in specific subgroups stratified for sex, NAT type, and tumor site.