ABSTRACT
Dietrich's disease, also known as Mauclaire's disease, is a rare condition characterized by avascular necrosis of the metacarpal heads, predominantly affecting adolescents. This case report aims to elucidate the diagnostic process and management of Dietrich's disease in adolescents. A 15-year-old male adolescent presented with left ring finger metacarpophalangeal joint pain and restricted range of motion following a remote history of sports-related trauma. Clinical examination revealed tenderness and limited flexion at the affected joint. Radiographic evaluation demonstrated characteristic features of Dietrich's disease, including lucency and loss of height in the fourth metacarpal head and volar subluxation of the ring finger. Computed tomography and magnetic resonance imaging (MRI) confirmed the diagnosis, revealing flattening of the metacarpal head, subchondral marrow edema, and joint effusion consistent with avascular necrosis. The pathogenesis of Dietrich's disease remains incompletely understood, likely involving acquired deficits in arteriolar blood supply. Radiographic and MRI findings aid in diagnosis, distinguishing it from other conditions such as chondroblastoma and osteomyelitis. Treatment options range from conservative management to surgical interventions, depending on the severity of symptoms. Dietrich's disease, though rare, should be considered in adolescents presenting with metacarpal pain and predisposing factors such as trauma or steroid use. Recognition of characteristic imaging features is essential for accurate diagnosis and appropriate management in adolescent populations. This case highlights the importance of early detection and multidisciplinary management in adolescents with Dietrich's disease to optimize outcomes and preserve hand function.
ABSTRACT
CT perfusion (CTP) imaging is increasingly used for routine evaluation of acute ischemic stroke. Knowledge about the different types of CTP software, imaging acquisition and post-processing, and interpretation is crucial for appropriate patient selection for reperfusion therapy. Conventional vendor-provided CTP software differentiates between ischemic penumbra and core infarct using the tiebreaker of critically reduced cerebral blood volume (CBV) values within brain regions showing abnormally elevated time parameters like mean transit time (MTT) or time to peak (TTP). On the other hand, RAPID automated software differentiates between ischemic penumbra and core infarct using the tiebreaker of critically reduced cerebral blood flow (CBF) values within brain regions showing abnormally elevated time to maximum (Tmax). Additionally, RAPID calculates certain indices that confer prognostic value, such as the hypoperfusion and CBV index. In this review, we aim to familiarize the reader with the technical principles of CTP imaging, compare CTP maps generated by conventional and RAPID software, and discuss important thresholds for reperfusion and prognostic indices. Lastly, we discuss common pitfalls to help with the accurate interpretation of CTP imaging.
Subject(s)
Brain Ischemia , Ischemic Stroke , Stroke , Humans , Tomography, X-Ray Computed/methods , Stroke/diagnostic imaging , Software , Infarction , PerfusionABSTRACT
Background: Breast cancer incidence is increasing in the Gulf Cooperation Council (GCC) countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates. Aims: This study analysed geographical patterns, time trends, and age distribution of female breast cancer incidence among nationals and non-nationals in GCC countries. Methods: Available cancer registry data for 1979-2016 were retrieved for the GCC countries. Age-standardized rates (ASRs) per 100 000 women were calculated using the World standard population. Comparisons were made by calculating comparative incidence figures. Results: From 1998 to 2012, incidence among nationals was highest in Bahrain (ASR 61.85), Kuwait (ASR 52.66), and Qatar (ASR 56.90) and lowest in Saudi Arabia (ASR 19.76), Oman (ASR 22.33), and United Arab Emirates (ASR 31.05). In the most recent period, data were available only in Qatar (2014-2016) and Saudi Arabia (2013-2015). Non-nationals and nationals in Qatar had higher incidence rates than in Saudi Arabia. Incidence among nationals in Qatar was at least twice that in Saudi Arabia (comparative incidence figure 2.32). Incidence among non-nationals in Qatar was 3 times higher than in Saudi Arabia. Among nationals in Kuwait, 10.8% of cases of breast cancer occurred in women aged < 40 years in 2008-2012, compared with 24.2% in non-nationals in Qatar in 2014-2016. Conclusion: Breast cancer incidence has increased over time among women in most GCC countries, likely reflecting the improvements in healthcare access and screening programmes. Nationals and non-nationals developed breast cancer at a younger age than women in other high-income countries. Increased screening uptake is still required in the region. Evidence-based, locally-informed interventions should be implemented to address risk factors specific to the nationals and non-nationals in the GCC countries.
Subject(s)
Breast Neoplasms , Female , Humans , Breast Neoplasms/epidemiology , Incidence , Qatar/epidemiology , Saudi Arabia/epidemiology , Kuwait/epidemiology , Oman/epidemiology , United Arab Emirates/epidemiology , Bahrain/epidemiologyABSTRACT
Patients who have received haematopoietic stem cell transplantation (HSCT) have a high rate of pulmonary complications, and in this immunosuppressed population, fungal pneumonia is of great concern. Fungal pneumonia can have a similar appearance to non-infectious pulmonary processes in HSCT patients, and radiologists should be familiar with the subtle features that may help to differentiate these disease entities. The focus of this article is on the diagnosis of fungal pneumonia in HSCT patients with an emphasis on radiologists' roles in establishing the diagnosis of fungal pneumonia and the guidance of clinical management.
ABSTRACT
The ever-growing prevalence of tuberculosis is a cause for concern among both developing and developed countries. Abdominal tuberculosis is the most common site of extrapulmonary tuberculosis and involves almost all of the visceral organs. Clinical presentation of abdominal tuberculosis is often non-specific. Thus, having a high index of clinical suspicion is necessary to aide early diagnosis and guide prompt initiation of appropriate treatment. In this review, we focus on the entire spectrum of abdominal tuberculosis and other diseases mimicking it with an emphasis on their imaging findings.
Subject(s)
Tuberculosis , Abdomen , Diagnostic Imaging , Humans , Tuberculosis/diagnostic imagingABSTRACT
Breast cancer is the most common type of cancer in women and notwithstanding important therapeutic advances, remains the second leading cause of cancer-related death. Despite extensive research relating to the hormone ghrelin, responsible for the stimulation of growth hormone release and appetite, little is known of the effects of its unacylated form, especially in cancer. The present study aimed to characterize effects of unacylated ghrelin on breast cancer cells, define its mechanism of action, and explore the therapeutic potential of unacylated ghrelin or analog AZP-531. We report potent anti-tumor effects of unacylated ghrelin, dependent on cells being cultured in 3D in a biologically-relevant extracellular matrix. The mechanism of unacylated ghrelin-mediated growth inhibition involves activation of Gαi and suppression of MAPK signaling. AZP-531 also suppresses the growth of breast cancer cells in vitro and in xenografts, and may be a novel approach for the safe and effective treatment of breast cancer.
Subject(s)
Antineoplastic Agents/pharmacology , Ghrelin/pharmacology , Peptide Fragments/pharmacology , Peptides, Cyclic/pharmacology , Spheroids, Cellular/drug effects , Acylation , Animals , Apoptosis/drug effects , Breast Neoplasms/drug therapy , Cell Culture Techniques , Cell Line, Tumor , Female , Ghrelin/chemistry , Humans , MCF-7 Cells , Mice , Mice, Inbred BALB C , Mice, Nude , Mice, SCID , Xenograft Model Antitumor AssaysABSTRACT
Obesity is a risk factor for estrogen receptor-positive (ER+) breast cancer after menopause. The pro-proliferative effects of estrogens are well characterized and there is a growing body of evidence to also suggest an important role in tumorigenesis. Importantly, obesity not only increases the risk of breast cancer, but it also increases the risk of recurrence and cancer-associated death. Aromatase is the rate-limiting enzyme in estrogen biosynthesis and its expression in breast adipose stromal cells is hypothesized to drive the growth of breast tumors and confer resistance to endocrine therapy in obese postmenopausal women. The molecular regulation of aromatase has been characterized in response to many obesity-related molecules, including inflammatory mediators and adipokines. This review is aimed at providing an overview of our current knowledge in relation to the regulation of estrogens in adipose tissue and their role in driving breast tumor development, growth and progression.
Subject(s)
Breast Neoplasms/metabolism , Estrogens/metabolism , Obesity/metabolism , Adipose Tissue/metabolism , Adipose Tissue/pathology , Aromatase/metabolism , Breast/metabolism , Breast/pathology , Breast Neoplasms/etiology , Breast Neoplasms/pathology , Disease Progression , Female , Humans , Menopause , Obesity/complications , Obesity/pathology , Receptors, Estrogen/metabolismABSTRACT
DNA barcoding technique has made it possible to authenticate various species used for food and medicinal purposes. In the identification of seafood species, studies are concentrated in North America, Europe, and Asia. Elsewhere, including countries in the Middle East and North Africa, studies of this sort are scarce. This study focuses on packaged fresh or minimally processed fish fillet available at eight major supermarket chains in Qatar. A cocktail of eight primers attached with M13 tails established for fish species identification was adopted to facilitate PCR and sequencing. Sequences were compared with those available in the Barcode of Life Databases (BOLD Systems) and BLAST in NCBI databases. Among the 62 unique fish packages with resolved sequences, only three are confirmed to be mislabeled, at a rate of about 5%. Two of the substituted species are high value items while the third species was replaced by another, equally low-cost species. The relatively low rate of mislabeling in the samples is perhaps a result of strict local food safety regulations, which may have led to high consistency between the package labels and their contents.