Objective: Geriatric patients have more complicated appendicitis, which leads to higher morbidity and mortality rates. Sarcopenia has been shown to have a negative impact on patients undergoing surgery. This study aims to reveal the predictive value of computerized tomography‐assessed (CT‐assessed) sarcopenia for complicated appendicitis in geriatric patients.Methods: One‐hundred fifty‐four patients’ with acute appendicitis age, gender, co‐morbidities, appendicitis status, and body mass index (BMI) values were analyzed. The skeletal muscle index (SMI) and related measurements were evaluated.Results: Fifty‐two percent of the patients had complicated, and 48% had uncomplicated appendicitis. There was a statistically significant difference between uncomplicated and complicated cases regarding BMI, SMI, and muscle area values (P < 0.05). The cutoff point by Receiver Operating Characteristic Curve analysis was conducted for SMI and showed 71% sensitivity and 52% specificity (P = 0.042). Multivariate analysis has shown that comorbidities are significantly more associated with complicated appendicitis than sarcopenia.Conclusion: Geriatric patients with lower BMI, decreased muscle area, and CT‐detected sarcopenia have an increased risk of complicated appendicitis. Comorbidities are also important risk factors. Surgeons should be aware of factors leading to complicated appendicitis, which may cause higher morbidity and mortality rates in elderly patients.

Congestive Heart Failure (CHF) is a major contributor to emergency department (ED) visits and mortality. Traditional diagnostic tools may not fully capture systemic venous congestion, which is a critical factor in CHF prognosis. The Venous Excess Ultrasound Score (VExUS) is a novel ultrasonographic tool that systematically evaluates venous congestion. This study aimed to assess the effectiveness of VExUS scores in predicting 30-day mortality in patients presenting to the ED with CHF symptoms. This was a prospective, cross-sectional study involving 47 adult patients presenting to the ED with clinical signs of CHF. Patients were assigned VExUS scores of 1, 2, or 3 based on ultrasonographic findings. Laboratory values, PV Doppler flow patterns, and diameters were recorded. Logistic regression and ROC curve analyses were conducted to evaluate the predictive value of VExUS scores and PV diameter on 30-day mortality. Higher VExUS scores were associated with increased mortality. Specifically, patients with a VExUS score of 3 had significantly higher 30-day mortality compared to those with a score of 1 (OR = 15.92, p = 0.037). A PV diameter ≥ 10 mm predicted mortality with 92.31% sensitivity. Significant correlations were also found between VExUS scores and PV Doppler findings, PV diameter, and other ultrasonographic parameters. Higher VExUS scores appear to be associated with increased 30-day mortality in CHF patients presenting to the emergency department, supporting its potential utility as a noninvasive prognostic tool. Its integration into routine ED assessment may help support risk stratification and guide more targeted management strategies. Not applicable.

Şahinde Atlanoğlu, Muhammed Fatih Topuz. JKAOMS 2022;48:149-54. https://doi.org/10.5125/jkaoms.2022.48.3.149

Objectives: In COVID-19, severe lung involvement develops in some patients. The reason for the predisposition to lung involvement in some patients is not yet fully understood. Genetic variabilities in angiotensin-converting enzyme (ACE) may explain why some patients are more susceptible to lung injury. Thus, the ACE gene insertion/deletion (I/D) polymorphism was investigated in COVID-19 patients with and without lung involvement. Methods: The study involved 216 patients who were divided into two groups as with and without pulmonary involvement according to their thoracic computed tomography (CT) scan findings. The ACE I/D gene polymorphism was determined. Results: Carriers of the DD genotype had a 4.05-fold (OR=4.05, 95% CI: 1.66–9.86, p=0.001) greater incidence of pulmonary involvement. The probability of lung involvement was 2.41-fold higher in D allele carriers (OR=2.41, 95% CI: 1.62–3.60, p=0.000). The I allele was found to be protective and diminished the occurrence of lung involvement (OR=0.41, 95% CI: 0.28–0.62, p=0.000). Conclusions: In COVID-19 patients, the I allele may lower the risk of lung injury and provide a protective effect. Conversely, the D allele may raise the risk of lung injury and lead to poor outcomes.

The foramen of Huschke (FH) is a developmental bone defect located anteroinferior to the external auditory canal. In this study, the frequency of FH and the presence of TMJ herniation into the external auditory canal were investigated using high-resolution computed tomography (HRCT) of the temporal bone in patients with FH. In addition, it was aimed to determine whether there is a relationship between the degree of mastoid pneumatization and mastoid volume and the presence of FH. The HRCT images of 352 patients were retrospectively evaluated for the presence of FH and TMJ herniation into the external auditory canal. The degree of pneumatization was determined in 50 patients with FH and 53 patients without FH, and the mastoid volume was measured. Of the 704 temporal bones, 50 (7.1%) were detected to have FH 16 (4.5%) on the right and 34 (9.7%) on the left. The incidence of FH was higher in women on the right than in men (p<0.01). There was strong correlation between the FH width and age for the left side (r=0.466, p0.05). TMJ herniation into the external auditory canal was detected in one of the patients with FH. We could not find a relationship between mastoid bone pneumatization and FH development. The presence of FH should be detected before TMJ and ear surgeries to prevent possible complications.

This study evaluated the success of large language models on radiology questions, analyzing language variations, temporal consistency, and performance against residents. We evaluated ChatGPT-5, Grok-4, Claude 4.5 Sonnet, and Gemini 2.5 Pro using 100 multiple-choice questions across 5 subspecialties. Linguistic impact (Turkish vs English) and 1-week temporal reliability were assessed. Performance was benchmarked against a control group of 18 radiology residents (years 1–3). Gemini 2.5 Pro achieved the highest accuracy (90%), followed by Claude 4.5 Sonnet (86%). All models and 3rd-year residents significantly outperformed junior residents. While no significant performance gap existed between languages ( P = 1.000), Claude 4.5 Sonnet demonstrated superior temporal reliability (κ = 0.872) compared with the moderate consistency of Grok-4 and ChatGPT-5. High-performance large language models provide accurate radiology knowledge comparable with senior residents, showing significant potential for education. Future research must incorporate image-based datasets to determine clinical efficacy.