A comparative study between ciliary count and the degree of opacity of paranasal sinus CT scans in chronic sinusitis pre and post FESS.

OBJECTIVE: To investigate the relationship between the extent of sinus disease in chronic sinusitis as detected radiologically by computed tomography (CT) scan and the population of cilia (ciliary area) both before and after functional endoscopic sinus surgery (FESS). In a simple way this is a trial to statistically prove that the CT scan could be a valid indicator and a mirror of the histological status of the sinus mucosa. DESIGN: Twenty adult patients were enrolled in this study. Radiological extension of the sinus disease was quantitated using the classification proposed by Kennedy in 1992 and the ciliary population was studied using scanning electron microscopy and image analysis softwares. RESULTS AND CONCLUSION: The more advanced the sinusitis, as evidenced by CT scans, the more the expected reduction in the ciliary area (CA) and in the ciliary count. But after FESS the degree of ciliary regeneration does not depend statistically on the radiological condition of the sinuses and the degree of opacity prior to intervention, i.e. a statistically valid inverse relationship exists between the radiological stage of sinusitis and the ciliary population pre-operatively but the same relation does not extend to the ciliary population post-operatively.

Plasma visfatin and retinol binding protein-4 levels in patients with type 2 diabetes mellitus and their relationship to adiposity and fatty liver.

OBJECTIVES: We investigated whether plasma visfatin and binding protein-4 (RBP-4) levels correlate with obesity and type 2 diabetes mellitus (T2DM). DESIGN AND METHODS: Two groups were enrolled: Group 1: 40 patients with T2DM and Group 2: 40 age- and gender-matched healthy controls. Both groups were subdivided according to body mass index (BMI) into non-obese (BMI < 25 kg/m(2)) and obese subjects (BMI ≥ 30 kg/m(2)) (20 each). RESULTS: Plasma visfatin and RBP-4 levels were significantly increased in T2DM patients compared with controls with similar BMI values (for both p<0.001). Plasma visfatin and RBP-4 concentrations correlated with BMI, waist/hip ratio, insulin and homeostatic model assessment insulin resistance (HOMA(IR)). Visfatin and RBP-4 correlated with visceral fat and liver fat in diabetic patients (for both p<0.001). CONCLUSION: Visfatin level was increased in T2DM, possibly related to hyperglycemia. Plasma RBP-4 correlated positively with liver fat and HOMA(IR) which may reflect its effects on hepatic insulin sensitivity.

Assessment of bone mineral density by dual x-ray absorptiometry in dermatological patients treated by corticosteroids.

BACKGROUND: Corticosteroids are mainstay of dermatological therapy and they are also a well known cause of osteoporosis. The objective of the present study was to find out the influence of the systemic intake of corticosteroids, either by the oral route or by IV pulse administration, on bone mineral density in dermatological patients using dual X-ray absorptiometry (DXA). MATERIALS AND METHODS: This study was carried on 100 patients and 55 controls. The first group of patients included 55 patients undergoing long-term oral corticosteroid therapy daily and the second group included 45 patients who received IV dexamethasone pulse therapy. DXA was measured once for both the controls and patients in group 1. DXA was measured twice for patients in group 2, before starting pulse therapy (baseline DXA) and six months after regular treatment with pulse therapy (follow-up DXA). RESULTS: The results show that significant reduction in BMD occurs in both groups, however, oral corticosteroids produce significantly more reduction in BMD in the lumbar spine. BMD was not found to be affected by the cumulative doses of corticosteroids, the duration of daily oral corticosteroid intake, or the number of IV dexamethasone pulses. CONCLUSION: Corticosteroid treatment causes significant BMD loss in patients treated by either route. Prophylactic treatment against osteoporosis is mandatory in patients receiving either form of corticosteroids.

Magnetic resonance imaging in fetal anomalies: What does it add to 3D and 4D US?

OBJECTIVE: The objective of our study is to evaluate the contribution of adding MRI findings to sonographic data when assessing fetal anomalies and to determine how this addition may affect the management of pregnancy. STUDY DESIGN: We prospectively examined 26 fetuses who had sonographically suspected congenital anomalies over a period of 1 year. 2D/3D and 4D ultrasound, Doppler and magnetic resonant imaging was done for all patients. MRI was done within 1 week following US examination. The maternal age range was 18-39 years. The gestational age range was 15-38 weeks (mean age=29 weeks). Ultrasound and magnetic resonance findings were compared together. RESULTS: We reported different types of congenital anomalies including eight cases of isolated central nervous system anomalies, four abdominal, five musculoskeletal anomalies, seven cases of renal anomalies and two cases of Meckel Gruber syndrome. MRI and sonography showed concordant findings in 18 cases. MRI changed the diagnosis in five cases and provided additional information in three cases. Ultrasound was superior to magnetic resonance imaging in three cases. CONCLUSION: Our results showed that fetal MR imaging can be used as a complementary modality to US in diagnosing fetal abnormality in which US findings are inconclusive or equivocal.