Investigation of incidental findings of temporomandibular joint disorders on brain magnetic resonance imaging in three-dimensional T2-weighted SPACE sequence performed for brain imaging.

Objectives: The study aimed to determine the temporomandibular joint (TMJ) findings, to investigate the prevalence contribution of this sequence on cases in which cranial magnetic resonance examination was performed and three-dimensional (3D) T2-SPACE (T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions) sequence was used by retrospectively scanning the magnetic resonance imaging (MRI) archive of our hospital, and to reveal the advantages of the 3D-T2 SPACE sequence in patients with TMJ disorders. Patients and methods: The cross-sectional retrospective study was conducted with 499 patients (289 females, 210 males; mean age: 50.1±17.7 years; range, 8 to 92 years) who underwent brain MRI and had 3D-T2 SPACE between March 1, 2021 and March 1, 2022. Two radiologists analyzed the TMJs of the subjects included in the study in 3D-T2 SPACE sequences. Results: At least one incidental finding was detected in the TMJ in 37.1% (n=185) of the patients included in our study. In our study, the most common (13.6%) MRI findings were osteoarthritic changes and synovial cysts. Joint effusion (13.2%) and disc displacement (9%) were less frequent. When the relationship between the age of the patients and the presence of incidental findings, degeneration, effusion, disc displacement, and cyst was examined, the age of the patients with incidental findings (p=0.001) and osteoarthritic changes (p<0.001) was statistically significantly higher. Conclusion: Incidental findings, particularly osteoarthritic changes and synovial cysts, can be seen quite commonly in the TMJ in brain MRI using 3D T2-SPACE sequences in the general population. The 3D T2-SPACE sequence provides valuable information in the recognition of TMJ disorders.

The predictive role of laboratory parameters in cardiovascular risk assessment in obese.

The significance of cardiovascular diseases in mortality is indisputable. It is well-established that cardiovascular diseases are more prevalent among individuals with obesity. This study aimed to determine the predictive value of easily accessible hematological and biochemical parameters in assessing cardiovascular risk among obese patients. The study was designed as an observational retrospective. Department of Family Medicine, study was carried out between 25/06/2022 to 30/10/2022. The data of 439 obese patients were analyzed retrospectively. Using the online Heart Score system, the patients were classified into low, medium, high, and very high cardiovascular risk categories. The hemogram and certain biochemistry values of the patients at the time of admission were examined. Receiver operating characteristic (ROC) analyses were conducted to discriminate cardiovascular risk classes based on laboratory values. Markers with high diagnostic value, including a high area under the curve (AUC) value, sensitivity, and specificity, were presented. Significant differences were observed between the groups in terms of age, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein, glucose, HbA1c, hemoglobin, platelet count, neutrophil (NEU) count, and platelet-lymphocyte ratio parameters (P < .05). The white blood cell count and NEU count of patients in the high-risk groups were found to have significantly higher AUC values compared to the moderate-risk group (AUC values of .737 and .779, respectively). The white blood cell and NEU parameters were found to have a positive predictive value in estimating the degree of cardiovascular risk. These parameters can potentially serve as biomarkers in identifying individuals at high risks for cardiovascular diseases.

The Use of Predictive Laboratory Tests in Rapid Triage of COVID-19 Pandemic Outpatient Clinic Patients.

BACKGROUND: Patients who come to the emergency pandemic outpatient clinic with a pre-diagnosis of COVID-19 are still a burden on the health system. Rapid triage of patients is important to reduce transmission. The aim of this study is to evaluate the biochemistry and hemogram results of real-time reverse transcription-polymerase chain reaction (RT-PCR) positive and negative patients in the emergency pandemic outpatient clinic and to investigate predictive values of the initial tests that will help to make rapid diagnosis. METHODS: Patients who applied to the emergency pandemic outpatient clinic with the suspicion of COVID-19 between November 01, 2020 and January 01, 2021 were evaluated with RT-PCR and laboratory examinations. RESULTS: A total of 551 patients were included in the study. The mean age of the patients was 50.31 ± 18.47 (min. 18 - max. 94), and 47.2% (n = 260) of the patients included in the study were male and 52.8% (n = 291) were female. In the comparison of hemogram parameters, we found that mean platelet volume (MPV) was significantly higher (p = 0.023), whereas white blood cell (WBC), platelet counts (PLT), lymphocyte and neutrophil values were significantly lower in RT-PCR positive patients (p < 0.001). There were no significant differences between the PCR positive and negative patients in terms of other parameters. In the comparison of biochemical parameters, we found that lactate dehydrogenase LDH (p = 0.001), creatinine (p = 0.002), and AST (p < 0.001) values were significantly higher in PCR positive patients, while there were no significant differences in terms of other biochemical parameters (p > 0.05). CONCLUSIONS: Our study results show that the practical quick-look hemogram and MPV can be used as a specially evaluated parameter in the rapid management of the first application COVID-19 patients. In addition, biochemically high levels of LDH and creatinine can be used to guide the clinician in terms of early hydration of the patient with a pre-diagnosis of COVID-19 to alleviate acute kidney damage.

Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy.

BACKGROUND: Acute appendicitis (AA) is the most frequently seen surgical emergency in pregnant women and the most frequently encountered cause of non-obstetric acute abdomen. Due to the physiological and anatomical changes that occur during pregnancy and the limited use of radiological methods, it is difficult to diagnose AA during pregnancy. These conditions increase the risk of morbidity and mortality; therefore, it is crucial to identify ideal laboratory markers that can be utilized to diagnose disease. METHODS: One hundred and ten pregnancies that fulfilled the inclusion criteria for AA diagnosis were retrospectively analysed between 2010 and 2021. Markers with high diagnostic values were discussed. RESULTS: The patients were divided into three groups as follows; Group I: negative appendectomy (n = 19); Group IIa: uncomplicated appendicitis (n = 59); Group IIb: complicated appendicitis (n = 32). There was no statistically significant difference in mean age or gestational week (P > 0.05). Group IIb had a higher rate of complications and a longer length of hospital stay (P < 0.05). There were significant differences between the groups in terms of white blood cell (WBC), neutrophil, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein, lymphocyte-to- C-reactive protein ratio, total, direct, and indirect bilirubin values (P < 0.05). While platelet and lactate dehydrogenase (LDH) values did not differ substantially between groups, both were found to have a high diagnostic value. CONCLUSION: It was concluded that WBC, neutrophil, NLR, PLR, total, direct and indirect bilirubin levels could be utilized to diagnose AA. Moreover, levels of WBC, neutrophil, NLR, platelet, PLR, LDH, total, direct and indirect bilirubin can be utilized to diagnose complicated appendicitis.

Clinical, biochemical, and echocardiographic evaluation of neonates with vitamin D deficiency due to maternal vitamin D deficiency.

OBJECTIVE: There are a few number of case reports and small-scale case series reporting dilated cardiomyopathy due to vitamin D-deficient rickets. The present study evaluates the clinical, biochemical, and echocardiographic features of neonates with vitamin D deficiency. PATIENTS AND METHODS: In this prospective single-arm observational study, echocardiographic evaluation was performed on all patients before vitamin D3 and calcium replacement. Following remission of biochemical features of vitamin D deficiency, control echocardiography was performed. Biochemical and echocardiographic characteristics of the present cohort were compared with those of 27 previously published cases with dilated cardiomyopathy due to vitamin D deficiency. RESULTS: The study included 148 cases (95 males). In the echocardiographic evaluation, none of the patients had dilated cardiomyopathy. All of the mothers were also vitamin D deficient and treated accordingly. Comparison of patients with normocalcaemia and hypocalcaemia at presentation revealed no statistically significant difference between the ejection fraction and shortening fraction, while left ventricle end-diastolic diameter and left ventricle end-systolic diameter were higher in patients with hypocalcaemia. Previously published historical cases were older and had more severe biochemical features of vitamin D deficiency. CONCLUSION: To the best of our knowledge, in this first and largest cohort of neonates with vitamin D deficiency, we did not detect dilated cardiomyopathy. Early recognition and detection before developing actual rickets and preventing prolonged hypocalcaemia are critically important to alleviate cardiac complications.

Comparison of the effects of articaine, tetracaine, and lidocaine application on pain and hemorrhage during and after nasal pack removal.

OBJECTIVE: We purposed to compare the effects of certain local anesthetic applications on pain and hemorrhage caused by nasal pack removal. METHODS: Design: Prospective, placebo-controlled study. Setting: Ataturk University Medical Faculty Hospital. This study was done in 90 patients who applied nasal packing after septoplasty. All patients were divided randomly into four groups. Each group was applied 2% lidocaine, 2% tetracaine, 4% articaine or 0.9% sodium chloride (NaCl) into their Merocel packs 15 min before removing. Verbal analog scale (VAS) score was registered from all patients, and the amount of hemorrhage was noted during the removal of the nasal packs and then for 30 min. RESULTS: The study groups had significantly better pain scores than the control group during nasal pack removal and after 5 min (p<0.001). The articaine and the lidocaine groups had also better pain scores than the control group at 15th min after the removal of the nasal packs (p<0.05), but the tetracaine group had no better pain scores than the control group, which is statistically significant at p>0.05. Analysis of bleeding scores after the removal of packs showed that the articaine and the lidocaine groups had better bleeding scores than the control group (p<0.004 and p<0.033, respectively). CONCLUSION: Topical articaine application into nasal packs just before removing in the patients who underwent septoplasty can be safely used for less pain, less hemorrhage, and more patient tolerance.

Assessment of tebuconazole exposure on bovine testicular cells and epididymal spermatozoa.

This study is the first to investigate the effects of tebuconazole (TEB) on the physiological functions of bovine testicular cells and epididymal spermatozoa. Motility and plasma membrane integrity of spermatozoa exposed to TEB (0.001-100 µM) were evaluated at different incubation times (0-6 h), while TEB-induced spermiotoxicity was assessed after 24 h in cell cultures. Testicular cells, obtained from the parenchyma of bovine testes, were seeded at 1.0 × 104 and 1.5 × 106 cells/well in 96- and 12-well culture plates and incubated for 48 h in culture media containing TEB (0.001-100 µM) to evaluate cytotoxicity and hormone release, respectively. TEB did not affect the motility and plasma membrane integrity. However, significant spermiotoxicity occurred at higher TEB (1-100 µM) concentrations (P < 0.05) compared to control and lower doses. Although no dose caused cytotoxicity in testicular cells (P > 0.05), 1 and 100 µM TEB caused a significant increase in testosterone secretion (P < 0.05). As a result, high doses of TEB (1-100 µM) had slightly suppressive effects on spermatozoa; however, these doses had stimulatory effects on testosterone secretion by testicular cells. It appears that the disruption of hormonal homeostasis of testicular cells after TEB exposure may result in metabolic and especially reproductive adverse effects in bulls.

The Availability of Echinococcus IgG ELISA for Diagnosing Pulmonary Hydatid Cysts.

OBJECTIVE: In this study, we researched the availability of Echinococcus IgG ELISA in pulmonary hydatid cysts. MATERIALS AND METHODS: Between January 2008 and December 2015, 93 successive cases, which were studied in preoperative Echinococcus IgG and histopathologically found to have pulmonary hydatid cysts, were retrospectively analyzed. Age and sex of the cases and the cyst's location, number, size, spread to other organs outside the lungs, and its condition as intact or ruptured were reviewed. RESULTS: Forty-seven (50.5%) patients were male and 46 (49.5%) patients were female; the mean age was 27.7±19.6 years. While in 56 (60.2%) cases, only lung cysts were detected, 32 (34.4%) cases presented with both lung and liver cysts. While lung cysts were single in 71 (76.3%), they were multiple in 22 (23.6%) cases (between 2 and 20 pieces). In 48 (51.6%) cases, cysts were in the right lung, and in 32 (34.4%) cases, they were in the left. In 13 (14%) cases, cysts presented in both the right and left lungs. The mean diameter of the pulmonary cysts was 6.4 cm (ranging from 2 to 19 cm). In 53 (57%) cases, hydatid cysts were ruptured, whereas in 40 (43%) cases, the cysts were intact. While general Echinococcus IgG was found to be positive in 53 (57%) cases, it was negative in 40 (43%) cases. There were 53 ruptured cases, and 48 (90.6%) of them were test-positive; however, the test was positive in only 5 (12.5%) out of the 40 cases where the cysts were intact (p<0.001). A statistically significant correlation has not been found between IgG and patient age, gender, cyst location, number of cysts, cyst diameter, and extrapulmonary involvement. CONCLUSION: Our study demonstrated that the most important factor that affects the positivity of Echinococcus IgG is the rupture of cysts. When ruptured cysts become confusing, Echinococcus IgG can contribute toward a diagnosis.