Relationship of The Characteristic Imaging Findings of Breast Cancer with Molecular Subtypes in Young Women.

BACKGROUND: The characteristic imaging findings of breast cancer in young women are not yet fully understood. It causes a delay in diagnosis by mixing with benign findings. OBJECTIVE: To evaluate the relationship between the imaging and histopathological features of breast cancer in women aged under 40 years. METHODS: In our center, 537 suspicious lesions were detected in a total of 15,223 adult female patients under 40 years who were evaluated by breast ultrasonography (US). As a result of the mammographic, histopathological, and immunohistochemical analysis, 101 lesions meeting the study criteria were included in the sample. RESULTS: The luminal subtypes of breast cancer mostly visualized as irregularly shaped spiculated lesions with calcification and architectural distortion mammography and presented as masses that were sometimes accompanied by increased echogenicity in the surrounding tissue on US. The human epidermal growth factor receptor 2 (HER2) enriched subtypes mostly had microlobulated or indistinct margins with heterogeneous echoes accompanied by high calcification on mammography. The triple-negative (TN) subtypes generally appeared as microlobulated lesions with angular or indistinct margins, hypo echogenicity, posterior enhancement or shadowing, and vascularization. CONCLUSION: Some radiological features of breast cancer in young women were found to be associated with molecular subtypes similar to other age groups in the literature. However, unlike other age groups, the incidences of the HER2-enriched subtype presenting with only calcification, TN subtypes presenting with circumscribed masses, and calcification were found to be low among the young women in our study.

Is initial optic nerve sheath diameter prognostic of specific head injury in emergency departments?

BACKGROUND: Emergency departments (EDs) are typically the first medical contact for patients with traumatic brain injury (TBI) and early diagnosis and treatment of intracranial pressure (ICP) in patients with neurotrauma primarily falls under the liability of emergency doctors. Monitoring ICP with optic nerve sheath diameter (ONSD) via tools has gained popularity among emergency service doctors. In this study, we aimed to evaluate the predictive value of ONSD for specific head injury on initial cranial tomography. METHODS: CT scans of 176 patients with a known intracranial pathology were retrospectively analyzed and compared with normal control CTs of 182 patients presented to ED at the same time interval. The attending radiologist analyzed all initial brain CT scans and randomly sampled control CTs were similarly assessed by the second senior radiologist whom were blind to the patients' medical histories and circumstances of TBI at the time of measurement. ONSD was measured at a distance of 3 mm behind the eyeball, immediately below the sclera. RESULTS: Right ONSD value was significantly higher in patients with herniation and SAH (p = 0,024 and 0,028, respectively). Left ONSD values was at the level of statistical significance and mean ONSD values was significantly higher in patients with SAH (p = 0.05 and 0.026, respectively). Right-left-mean ONSD values were statistically higher in study group with bilateral lesions on brain CT (p < 0,001). ONSD measurements and patient age were higher in patients who died (p < 0,001). CONCLUSIONS: ONSD measurement on initial brain CT is lesion dependent and indicates mortality.

Delayed neurologic sequelae of carbon monoxide intoxication.

Altered consciousness and accompanying neurological symptoms are both complex and challenging cases for emergency physicians. These are not specific and may be a sign of a variety of medical conditions including stroke and delayed neurological sequelae (DNS) is a recurrent transient neuropsychiatric consequence of CO intoxication. DNS produces a spectrum of varying symptoms and the diagnosis is primarily made on the basis of clinical features and radiological findings from CT and conventional MRI. In clinical practice, serious CO intoxication is treated only with oxygen therapy although no effective treatment exists. Emergency physicians play a major role in managing patients presenting with CO intoxication and preventing DNS.