Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis.

BACKGROUND: The prevalence of tobacco use among various cancer types in Iran remains a significant concern, necessitating a comprehensive analysis to understand the extent and patterns of consumption. This study aimed to systematically review and analyze existing literature to delineate the prevalence of tobacco use across different cancer types in Iran, thereby providing a robust basis for future interventions and policy formulations. METHODS: Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of literature available in PubMed and Scopus databases. The initial search identified 351 records, out of which 44 studies were selected based on their relevance and design. These studies spanned various time frames, starting from the 2001s up until 2022, and encompassed diverse geographical locations and cancer types in Iran. To avoid bias and potential data overlap, we opted to incorporate a single comprehensive study from the Golestan Cohort, encompassing all data, while excluding 10 other studies. Our final analysis incorporated data from 34 studies, which accounted for 15,425 patients and 5,890 reported smokers. Statistical analyses were performed to calculate the overall proportion of tobacco consumption and to conduct subgroup analyses based on different variables such as cancer types, gender, geographical locations, and types of tobacco used. RESULTS: The analysis revealed a substantial prevalence of tobacco use among cancer patients in Iran, with an overall consumption rate of 43%. This rate varied significantly, ranging from 10 to 88% across individual studies. Subgroup analyses further highlighted disparities in tobacco consumption rates across different demographics, geographic areas, and cancer types. Notably, the 'ever' smokers category exhibited the highest prevalence of tobacco use. The study also identified a worrying trend of high cigarette smoking rates, along with variable consumption patterns of other forms of tobacco, including waterpipe, 'Naas', and 'Pipe'. CONCLUSIONS: This systematic review and meta-analysis underscores a significant association between tobacco consumption and various cancer types in Iran, with a prevalence rate among cancer patients being three times higher than the average Iranian population. The findings indicate substantial heterogeneity in tobacco use patterns, emphasizing the need for targeted interventions to address this pressing health issue. The study serves as a critical resource for shaping future policies and strategies aimed at curbing tobacco use and mitigating its adverse effects on cancer prevalence in Iran.

CRISPR-Cas9 technology: As an efficient genome modification tool in the cancer diagnosis and treatment.

Cancer is the second most common cause of death globally and is a major public health concern. Managing this disease is difficult due to its multiple stages and numerous genetic and epigenetic changes. Traditional cancer diagnosis and treatment methods have limitations, making it crucial to develop new modalities to combat the increasing burden of cancer. The clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 9 (Cas9) system has transformed genetic engineering due to its simplicity, specificity, low cytotoxicity, and cost-effectiveness. It has been proposed as an effective technology to enhance cancer diagnosis and treatment strategies. This article presents the most recent discoveries regarding the structure, mechanism, and delivery methods of the highly powerful genome editing tool, CRISPR-Cas9. In terms of diagnosis, the article examines the role of CRISPR-Cas9 in detecting microRNAs and DNA methylation, and discusses two popular gene detection techniques that utilize the CRISPR-Cas system: DNA endonuclease-targeted CRISPR trans reporter and specific high sensitivity enzymatic reporter unlocking. Regarding treatment, the article explores several genes that have been identified and modified by CRISPR-Cas9 for effective tumorigenesis of common cancers such as breast, lung, and colorectal cancer. The present review also addresses the challenges and ethical issues associated with using CRISPR-Cas9 as a diagnostic and therapeutic tool. Despite some limitations, CRISPR-Cas9-based cancer diagnosis has the potential to become the next generation of cancer diagnostic tools, and the continuous progress of CRISPR-Cas9 can greatly aid in cancer treatment.

Effervescent tablet-assisted deep eutectic solvent based on magnetic nanofluid for liquid phase microextraction of tyrosine kinase inhibitors in plasma samples by high-performance liquid chromatography.

BACKGROUND: Tyrosine kinase inhibitors (TKIs) are efficient anti-cancer drugs. The analysis of TKIs in the treatment of cancer is important to achieve the highest anti-cancer effects with minimal toxicities. Herein, we report an efficient effervescent tablet-assisted deep eutectic solvent based on nanofluid (ETA-DES-NF) combined with HPLC-UV for the determination of three anti-cancer drugs (erlotinib, imatinib, and nilotinib) in human plasma samples. METHODS: In this method, a magnetic nanofluid composed of deep eutectic solvent (DES) and Fe3O4@SiO2 nanoparticles was used as an extraction solvent. The deep eutectic solvent acted as a carrier and stabilizer for Fe3O4@SiO2 nanoparticles. A tablet was used in the nanofluid for dispersion. The effervescent tablet was implemented to generate in situ CO2 and provide the effective dispersion of the sorbent into the sample solution for diminishing the extraction time and improving the extraction efficiency. Moreover, the magnetic nanofluid enhanced phase separation efficiency without centrifugation to collect the organic solvent. RESULTS: The synthesized nanofluid was characterized by Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), and vibrating sample magnetometry (VSM). The impact of main parameters, including the type and volume of DES, the composition of the tablet, the composition of the nanofluid and the composition of eluent, were optimized. According to the optimized conditions, the limits of detection (LODs) and the limits of quantitation (LOQs) were from 0.5-0.8 to 1.5-2.4 µg L-1 for imatinib, erlotinib, and nilotinib, respectively. The intra-day and inter-day relative standard deviations (RSD% n = 5) were determined to be 3.1-5% and 6.4-7.5%, respectively. CONCLUSIONS: The developed method displayed high sensitivity, low consumption of solvent, low cost, simplicity, high recoveries, short extraction time, and good repeatability for determination of three anti-cancer drugs in human plasma samples.

Gemfibrozil palliates adriamycin-induced testicular injury in male rats via modulating oxidative, endocrine and inflammatory changes in rats.

Adriamycin (ADR), an antineoplastic drug, is widely used to treat different types of cancers. Yet, the usage is limited because of its severe side effects on testis. On the other hand, gemfibrozil (GEM), as an anti-hyperlipidemic drug, has other pharmacological effects independent of lipid- lowering activity including anti-inflammatory and antioxidant properties. The present experiment was designed to investigate the effect of GEM on ADR-induced testicular injury in male rats. A total of 28 male Wistar rats were divided into 4 equal groups: Control; ADR; ADR + GEM; GEM. Serum level of testosterone, luteinizing hormone and follicle stimulating hormone were assessed. Also, testicular tissue oxidant/antioxidant markers (malondialdehyde, total antioxidant capacity, nitric oxide, superoxide dismutase, catalase, glutathione peroxidase and glutathione) and proinflammatory cytokines (tumor necrosis factor-α and interleukin-1ß) were measured. Histopathological studies were conducted on testes. GEM improved hormonal profile and antioxidant defenses in comparison with ADR-treated animals. GEM, significantly reduced the production of proinflammatory cytokines compared with ADR-treated animals. Hormonal and biochemical results were further supported by testicular histopathological findings. Thus, GEM might represent a promising therapeutic modality for the attenuation of testicular injury induced by ADR in clinic.

A novel and simple naphthol azo dye chemosensor as a naked eye detection tool for highly selective, sensitive and accurate determination of thiourea in tap water, juices and fruit skins.

In the present study, a highly accurate and sensitive azo-dye-based colorimetric sensor based on Eriochrome Black T (EBT) was proposed to detect and determine thiourea (TU). TU is truly an important toxic and carcinogenic hazardous pollutant as approved by EPA and IARC. This chemosensor shows a distinct color change from blue to pink during interaction with TU in aqueous medium. So EBT is capable as an applied tool for naked eye detection of TU as its color change is easily observed without any means. The sensing mechanism was also investigated using UV-vis absorption and FT-IR spectra. The linear range and the detection limit of TU sensing were respectively 0.15-18.5 µmol/L and 0.02 µmol/L. In addition, the relative standard deviation (RSD) based on ten repetitions calculated for two different TU concentrations 4.4 and 9.0 µmol/L were 2.3 % and 1.8 %, respectively. Besides its useful application as a naked eye detection tool, the advantages of the developed method include simplicity, elimination of tedious separation and pre-concentration steps, executable in neutral aqueous media, low costs, high accuracy, linear response for wide range of concentrations, low detection limit, high sensitivity, compatibility, and excellent selectivity. The concentration of TU in tap water, fruit juices or fruit skin samples can be visually detected and determined easily using this method. The results showed that EBT is an ideal colorimetric chemosensor for TU, which has been reported for the first time.

Gemfibrozil attenuates doxorubicin induced toxicity in renal tissues of male rats by reducing the oxidative insult and inflammation.

Nephrotoxicity is a significant side effect of doxorubicin (DXN) treatment. We investigated the protective effect of gemfibrozil (GEM) co-administration with DXN on DXN induced nephrotoxicity. We divided 28 male Wistar rats into four groups of seven. Group 1 received normal saline for 2 weeks. Group 2 received 15 mg/kg DXN for 2 weeks. Group 3 received DXN + GEM for 2 weeks. Group 4 received GEM for 2 weeks. On day 15 of the experiment, blood samples were collected, animals were sacrificed and kidneys were excised for biochemical and histological evaluation. We measured serum creatinine, blood urine nitrogen, renal malondialdehyde, nitric oxide, glutathione, superoxide dismutase, glutathione peroxidase, catalase, tumor necrosis factor-α and interleukin-1ß. GEM administration mitigated DXN induced nephrotoxicity. GEM co-administered with DXN attenuated the inflammatory and oxidative responses associated with DXN induced nephrotoxicity.

An uncommon presentation of hepatic hydatid cyst leading to biliary cirrhosis and portal hypertension.

Hydatid disease is an ongoing issue in endemic areas. Hydatid cysts can be seen in any organ but, liver is one of the most common involved organs. Cystobiliary communication as an overwhelming complication of hepatic hydatid cysts can contribute to the obstructive jaundice, cholangitis, sepsis and even biliary cirrhosis if left untreated. The patient we are trying to present is a 61-year-old farmer who presented with obstructive jaundice, multiple common bile duct stones and biliary cirrhosis attributed to a long-lasting untreated hepatic hydatid cyst. Portal hypertension is introduced to be an uncommon presentation of hydatid cyst. Extrinsic compression of the porta hepatis and obstruction of inferior vena cava are amongst major causes of hydatidosis leading up to portal hypertension as reported in the literature. Portal hypertension in the presented case is proposed to emerge from long-lasting cystobiliary communication ending in biliary cirrhosis.

A signal-on fluorescence based biosensing platform for highly sensitive detection of DNA methyltransferase enzyme activity and inhibition.

DNA methylation mediated by DNA methyltransferase (MTase) enzyme is internal cell mechanism which regulate the expression or suppression of crucial genes involve in cancer early diagnosis. Herein, highly sensitive fluorescence biosensing platform was developed for monitoring of DNA Dam MTase enzyme activity and inhibition based on fluorescence signal on mechanism. The specific Au NP functionalized oligonucleotide probe with overhang end as a template for the synthesis of fluorescent silver nanoclusters (Ag NCs) was designed to provide the FRET occurrence. Following, methylation and cleavage processes by Dam MTAse and DpnI enzymes respectively at specific probe recognition site could resulted to release of AgNCs synthesizer DNA fragment and returned the platform to fluorescence signal-on state through interrupting in FRET. Subsequently, amplified fluorescence emission signals of Ag NCs showed increasing linear relationship with amount of Dam MTase enzyme at the range of 0.1-20 U/mL and the detection limit was estimated at 0.05 U/mL. Superior selectivity of experiment was illustrated among other tested MTase and restriction enzymes due to the specific recognition of MTase toward its substrate. Furthermore, the inhibition effect of applied Dam MTase drug inhibitors screened and evaluated with satisfactory results which would be helpful for discovery of antimicrobial drugs. The real sample assay also showed the applicability of proposed method in human serum condition. This novel strategy presented an efficient and cost effective platform for sensitive monitoring of DNA MTase activity and inhibition which illustrated its great potential for further application in medical diagnosis and drug discovery.

A novel dye-based colorimetric chemosensors for sequential detection of Cu2+ and cysteine in aqueous solution.

An IDAs based chemosensing ensembles for sensitive and selective sequential detection of Cu2+ and cysteine (Cys) in 100% aqueous solution was designed on the basis of the complex formation between 4-(2-Pyridylazo)resorcinol (PAR). In the first step, PAR was used for colorimetric detection of Cu2+ in aqueous solution by the obvious color change. The detection limit (31.0 nmol L-1) for Cu2+ much lower than the guideline (31.5 µmol L-1) of WHO in drinking water. In the second step the produced ensemble (PAR-Cu2+), sensitively and selectively detected a low concentration of Cys via indicator displacement assay system. The detection limit for Cys was determined to be 72 nmol L-1. The colorimetric detection operation is low-cost using PAR and copper ion and has a simple operation without any further modifications. Any enzymatic reactions, separation processes, chemical modifications, and sophisticated instrumentations are also not required in this experiment. It could find applications for the detection of analytes in environmental, biological samples based on these results, dual logic gates (IMPLICATION and INHIBIT) were obtained by controlling the chemical inputs.

Ultrasonically formation of supramolecular based ultrasound energy assisted solidification of floating organic drop microextraction for preconcentration of methadone in human plasma and saliva samples prior to gas chromatography-mass spectrometry.

In this work, an ultrasonic-assisted supramolecular based on solidification of floating organic drop microextraction (UA-SM-SFO-ME) was developed as a green method for preconcentration of methadone prior to gas chromatography-mass spectrometry (GC-MS). The supramolecular solvent aggregates containing reverse micelles of 1-dodecanol in tetrahydrofuran (THF) were formed by ultrasonication that subsequently dispersed in the sample solution. Ultrasonic waves caused the fast formation of supramolecular solvent aggregates. In this work, ultrasonication was used in two phases: First phase, the formation of reverse micelles and the second phase, the dispersion of supramolecular solvent in the sample solution. Actually, ultrasonication was basic of this presented work. In order to provide the highest extraction efficiency, the influence of various parameters on the method performance (supramolecular solvent type and volume, disperser solvent condition, pH, extraction time and salt concentration) was investigated. Based on the obtained optimum conditions, the limits of detection (LODs) and the limits of quantitation (LOQs) were obtained 0.5-1.2 µg L-1 and 1.2-2.5 µg L-1 with preconcentration factors in the range of 182-191, in water and biological samples, respectively. Subsequently, the method was assessed for preconcentration of the methadone in human plasma and saliva samples.

Sensitive detection of methylated DNA and methyltransferase activity based on the lighting up of FAM-labeled DNA quenched fluorescence by gold nanoparticles.

DNA methylation of cytosine bases, which is catalyzed by methyltransferase enzymes, involve biochemical processes that contribute to gene expression and gene regulation in cells. Detection of abnormal patterns of both methylated DNA and methyltransferase enzyme activity at early stages could be considered as promising targets for early cancer diagnosis. In the present study, a novel and facile method is introduced for the sensitive detection of the M.SssI methyltransferase (M.SssI MTase) enzyme and methylated DNA based on the fluorescence recovery of FAM-labeled DNA coupled with gold nanoparticles (AuNPs). Thiol-modified probes were functionalized with AuNPs, which brought the FAM fluorophore into the close proximity of the AuNPs. This led to the overlap between the FAM fluorescence emission and AuNPs absorption spectra, introducing a FRET occurrence and causing fluorescence quenching. The hybridization of the probe and its complementary target provided specific CpG sites for M.SssI MTase enzyme activity. The methylation process gradually converted the quenched FAM fluorophore into an emissive fluorophore upon the addition of the MTase enzyme, and the observed fluorescence recovery proved the efficiency of the assay for the detection of MTase enzyme. The fluorescence intensity showed an increasing trend with M.SssI MTase enzyme activity in the range of 1-8 U mL-1 with a detection limit of 0.14 U mL-1. The addition of methylated ssDNA targets to a ssDNA FAM-labeled probe resulted in a DNA duplex formation, leading to a strong fluorescence signal emission due to the recovery of the fluorophore signal. Conversely, the unmethylated ssDNA target caused no changes in the fluorescence signal. In the presence of methylated DNA targets, the biosensor could specifically recognize it and accordingly trigger the methylated targets through a fluorescence enhancement in the range of 5-100 pM by monitoring the increase in the fluorescence intensity with a detection limit of 2.2 pM. The obtained results showed that the assay could realize the detection of M.SssI MTase and methylated DNA effectively in diluted human serum samples. Human serum conditions showed no significant interference with the assay performance, indicating that the present method has great potential for further application in real samples.

Are general practitioners well informed about fibromyalgia?

AIM: Fibromyalgia syndrome (FMS) is a common rheumatologic disorder characterized by easy fatigability, widespread musculoskeletal pain and sleep disorder. In spite of its high prevalence, general practitioners, as primary care providers, seem to have inadequate knowledge about FMS. This study aimed to assess Iranian general practitioners' knowledge about FMS and its treatment. METHOD: A detailed questionnaire (including items on signs and symptoms, diagnostic criteria and treatment) was completed by 190 general practitioners (54.7% male; mean age: 41 years). Data analysis was performed with SPSS for Windows 15.0 and awareness about all aspects of FMS was reported as percentages. RESULTS: About one-third (30%) of the participants had seen at least one case of FMS during their practice. Most subjects (62.7%) claimed to know 1-6 tender points. Only 3.2% knew 16-18 points. The common proposed symptoms of FMS were widespread pain (72.6%), excessive fatigue (72.6%), weakness (60.5%), sleep disorder (36.3%), anxiety (34.7%) and depression (34.2%). Wrong symptoms including elevated erythrocyte sedimentation rate and C-reactive protein, arthritis, joint swelling, weight loss and abnormal radiologic findings were selected by 27.9%, 18.9%, 14.7%, 12.6% and 2.1% of the physicians, respectively. Moreover, selective serotonin reuptake inhibitors, tricyclic antidepressant and pregabalin were identified as treatment options for FMS by, respectively, 45.8%, 22.1% and 15.3% of the participants. Finally, 52.1% and 23.7% of the subjects incorrectly considered nonsteroidal anti-inflammatory drugs and corticosteroids as treatment modalities for FMS. CONCLUSION: Iranian general practitioners are not well informed about FMS. Therefore, FMS should be specifically integrated in continuing medical education programs and undergraduate medical training curriculum.

Bovine lactoferrin ameliorates antioxidant esterase activity and 8-isoprostane levels in high-cholesterol-diet fed rats.

The main aim of the present study was to show the effect of bovineLactoferrin (bLF), an 80 kD iron-binding glycoprotein, its application on antioxidant esterase activities and 8-isoprostane changes in high-cholesterol-diet fed (HCD-Fed) rats. The 44 adult Sprague-Dawley male rats were randomly assigned into four experimental groups. They were randomly assigned into four equivalent groups (n = 11). The groups included the control group which was fed with normal diet, bLF group, the third group which were made hypercholesterolemia by being fed with high cholesterol diet, and the last group which consisted of hypercholesterolemia rats treated with bLF (HCD + bLF) for 4 weeks (200 mg.kg-1 per day wt. dissolved in 0.9% normal saline).After 4 weeks, the serum Paraoxonase1 (PON1), Arylesterase (ARE) activity and 8-isoprostane with lipid profile were measured. Upon treatment with the bLF, the decrease in LDL-Cholesterol (LDL-C), Glucoses, Triglyceride (TG) and Total-Cholesterol (TC) levels and an increase in HDL-Cholesterol (HDL-C) level were observed. The co-administration of bLf for 4 weeks had decreased the 8-isoprostane levels significantly (P < 0.001) (86.36 ± 7.1 vs 117.18 ± 8.62) when compared to hypercholesterolemia-induced rats. Also, the Atherogenic Index (AI) in HCD + bLF group showed a significant decrease as compared to the HCD group (P < 0.001) (0.37 ± 0.07 vs 0.57 ± 0.09). The results indicated that bLF was effective against oxidative stress by its ability to increase PON1 activity and reduce the lipid peroxidation in high-cholesterol-fed rats.

Musculoskeletal symptoms among handicraft workers engaged in hand sewing tasks.

OBJECTIVES: This study was conducted to determine the prevalence of musculoskeletal symptoms and associated risk factors among Iranian handicraft workers engaged in different hand sewing tasks. METHODS: Data were collected using questionnaires (including the Nordic Musculoskeletal Questionnaire) as well as direct observations of posture (using the Rapid Upper Limb Assessment [RULA] method) from 632 workers including carpet handicraft workers (n=222), textiles handicraft workers (n=209), and leather handicraft workers (n=201) in Tabriz, Iran. RESULTS: The response rate was 88.8%. The overall prevalence of musculoskeletal complaints, particularly in the neck (57.9%), lower back (51.6%), and shoulders (40.5%) was relatively high. The prevalence of neck and shoulder pain was higher among females and with increasing age. Working posture and fast working were associated with neck, shoulder, and lower back pain. Years worked as a sewing worker was associated with neck and lower back pain. Long duration of continuous sitting work (>2 h) without a break was associated with neck pain. Body mass index, marital status, sport/physical activity, smoking, daily working hours, job satisfaction, and perceived pressure due to work had no effect. CONCLUSIONS: The findings indicate a high prevalence of musculoskeletal pain among the studied handicraft workers and emphasize the importance of individual, physical, and psychosocial aspects of hand sewing tasks in this regard.

Computed tomography features of pulmonary nocardiosis in immunocompromised and immunocompetent patients.

BACKGROUND: Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. MATERIAL/METHODS: CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). RESULTS: Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. CONCLUSIONS: Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition.

Gonadal vein tumor thrombosis due to renal cell carcinoma.

Renal cell carcinoma (RCC) had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC.

The spectrum of presentations of cryptogenic organizing pneumonia in high resolution computed tomography.

BACKGROUND: Various radiologic patterns of cryptogenic organizing pneumonia (COP) in X-rays have been reported for more than 20 years, and later, in computed tomography scans. The aim of the present study was to describe the spectrum of radiologic findings on high resolution computed tomography (HRCT) scans in patients with COP. MATERIAL/METHODS: HRCT scans of 31 sequential patients (mean age: 54.3±11 years; 55% male) with biopsy-proven COP in a tertiary lung center between 2009 and 2012 were reviewed by two experienced pulmonary radiologists with almost perfect interobserver agreement (kappa=0.83). Chest HRCTs from the lung apex to the base were performed using a 16-slice multi-detector CT scanner. RESULTS: The most common HRCT presentation of COP was ground-glass opacity (GGO) in 83.9% of cases, followed by consolidation in 71%. Both findings were mostly asymmetric bilateral and multifocal. Other common findings were the reverse halo (48.4%), parenchymal bands (54.8%) and subpleural bands (32.3%). Pulmonary nodules were found in about one-third of patients and were frequently smaller than 5 mm in diameter. Both GGOs and consolidations were revealed more often in the lower lobes. CONCLUSIONS: The main presentations of COP on HRCT include bilateral GGOs and consolidations in the lower lobes together with the reverse halo sign.

Comparison of diagnostic accuracy of dual-source CT and conventional angiography in detecting congenital heart diseases.

BACKGROUND: Cardiac dual-source computed tomography (DSCT) is primarily used for coronary arteries. There are limited studies about the application of DSCT for congenital heart diseases. The aim of this study was to determine the diagnostic value of DSCT in the cardiac anomalies. MATERIAL/METHODS: The images of DSCTs and conventional angiographies of 36 patients (21 male; mean age: 8.5 month) with congenital heart diseases were reviewed and the parameters of diagnostic value of these methods were compared. Cardiac surgery was the gold standard. RESULTS: A total of 105 cardiac anomalies were diagnosed at surgery. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DSCT were 98.25%, 97.9%, 98.1%, 99.07%, and 98.2%, respectively. The corresponding values of angiography were 95.04%, 98.7%, 97.8%, 98.1%, and 98%, respectively. Only one atrial septal defect (ASD) and two patent ductus arteriosus (PDA) were missed by DSCT. Angiography missed two ASD and two PDA. DSCT also provided important additional findings (n=35) about the intrathoracic or intraabdominal organs. CONCLUSIONS: DSCT is a highly accurate diagnostic modality for congenital heart diseases, obviating the need for invasive modalities. Beside its noninvasive nature, the advantage of DSCT over the angiography is its ability to provide detailed anatomical information about the heart, vessels, lungs and intraabdominal organs.

Features of idiopathic pulmonary alveolar proteinosis in high resolution computed tomography.

BACKGROUND: Although the crazy-paving pattern on computed tomography is characteristic for pulmonary alveolar proteinosis (PAP), it is not specific and has not been compared between idiopathic and secondary PAPs in the large studies. The aim of this study was to determine the high resolution computed tomography (HRCT) features of idiopathic PAP. MATERIAL/METHODS: HRCT images of 35 patients (mean age: 38±14years; 54.3% male) with idiopathic PAP (proved by bronchoalveolar lavage or biopsy) were reviewed by two experienced pulmonary radiologist and detailed findings were reported. RESULTS: The predominant HRCT presentation of PAP was interlobular septal thickening (ILST;100%) and ground glass opacities (GGOs; 91.7%), resulting in crazy-paving pattern (83%). All patients had diffuse bilateral lung involvement that was symmetric in 97%. ILST and GGO without crazy-paving were seen in 17% and 14.7%, respectively. The overall extent of parenchymal involvement was 50 to 75% in 80% of patients. Thirty three cases (94%) had areas of geographic sparing within the affected lung. Peripheral sparing was seen in 85.7% of patients, including three patterns with some overlap: costophrenic angle (80%), apices (60%), and subpleural (57%) sparing. Other HRCT findings were: consolidation (63%), pulmonary nodules (31.4%), mediastinal and/or hilar lymphadenopathy (23%), mass-like consolidation (17%), pleural effusion (8.6%), and honey combing (5.7%). All female patients (n=16) had crazy-paving, while 13 out of 19 (68%) male patients had crazy-paving on their lung HRCT (p=0.02). CONCLUSIONS: This study demonstrated that the predominant HRCT presentation of idiopathic PAP was interlobular septal thickening and ground glass opacities, resulting in crazy-paving pattern.

Solitary osteochondroma of the thoracic spine with compressive myelopathy; a rare presentation.

A 19-year-old man presented with a 5-year history of back pain radiating to the lower extremities and paresthesis of the toes during the last year. Plain X-ray revealed a large cauliflower shaped exophytic mass at the level of T8, T9 and T10 vertebrae. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an abnormal bony mass arising from the posterior arch of T9 with protrusion to the spinal canal and marked cord compression. The cortex and medulla of the lesion had continuity with those of the T9 vertebra. Surgical en bloc resection was performed and the patient's symptoms resolved. The histopathologic diagnosis was osteochondroma. In patients with symptoms of myelopathy, in addition to more common etiologies, one should also be aware of rare entities such as osteochondroma.