Computed tomography findings in COVID-19 and atypical pneumonia: a comparative study.

INTRODUCTION: Computed tomography (CT) has an important role in the rapid diagnosis, treatment, and management of lower respiratory tract infections. This study aimed to explore different imaging characteristics between Coronavirus disease 2019 (COVID-19) and atypical pneumonia (non-COVID-19) on chest CT of patients admitted to the emergency department. METHODOLOGY: CT features of 120 patients with positive Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase-polymerase chain reaction (RT-PCR) and 83 patients with negative SARS-CoV-2 by RT-PCR but positive respiratory tract sample test results for other respiratory pathogens were retrospectively evaluated, findings were recorded and compared between the two groups. RESULTS: Compared to non-COVID-19, COVID-19 patients were more likely to have a peripheral (60.5% vs. 23.8%, p < 0.001) and bilateral distribution (72.3% vs. 41.3%, p < 0.001), patchy consolidations (45% vs. 28.9%, p = 0.021), ground glass opacity (GGO) (94.2% vs. 83.1%, p = 0.011), crazy paving patterns (55% vs. 31.3%, p < 0.001); but less likely to have centrilobular nodules (15% vs. 62.7%, p < 0.001), pleural effusion (3.3% vs. 10.8%, p = 0.032), multifocal consolidations (7.5% vs. 21.7%, p = 0.003), and random distribution (1.7% vs. 46.3%, p < 0.001). CONCLUSIONS: There were significant differences between the CT patterns of patients with COVID-19 and other atypical pneumonia. The presence of patchy consolidations, GGO, crazy paving patterns with typical peripheral, bilateral distribution, and absence of centrilobular nodules, pleural effusion, and multifocal consolidations may help to differentiate COVID-19 from atypical pneumonia.

Sarcopenia and Myosteatosis Assessed by Magnetic Resonance Enterography May Predict Negative Outcomes in Patients with Crohn's Disease.

BACKGROUND: Limited research has examined the clinical consequences of sarcopenia and myosteatosis in Crohn's disease. This study aimed to determine the prevalence, risk factors, and effects of sarcopenia and myosteatosis on prognostic outcomes in Crohn's disease patients who underwent magnetic resonance enterography. MATERIALS AND METHODS: This retrospective observational study included 116 Crohn's disease patients who underwent magnetic resonance enterography between January 2015 and August 2021. Skeletal muscle index was the ratio of the cross-sectional area of skeletal muscles at the L3 vertebral level to the square of the neck in cross-sectional imaging. Sarcopenia was defined as skeletal muscle index <38.5 cm2/m2 in women and <52.4 cm2/m2 in men. Myosteatosis was considered positive if the ratio of the mean signal intensity of the psoas muscle to the mean signal intensity of the cerebrospinal fluid was above 0.107. RESULTS: Among the negative results in the post-procedure follow-up of the patients, a significant increase was observed in the sarcopenia group regarding abscess and the need for surgery (P < .05). Anti-tumor necrosis factor initiation was found to be significantly higher in the follow-up than in patients without myosteatosis (P = .029). In the multivariate model established with these variables, the presence of sarcopenia in the surgical follow-up was odds ratio = 5.34 (CI: 1.02-28.03, P = .047) and was found to be significantly associated with the increased risk. CONCLUSIONS: The presence of myosteatosis and sarcopenia detected in magnetic resonance enterography may be a harbinger of negative outcomes in Crohn's disease patients. Nutritional support should be provided to these patients with the potential to alter the course of the disease.

The brainstem connections of the supplementary motor area and its relations to the corticospinal tract: Experimental rat and human 3-tesla tractography study.

Although the supplementary motor area (SMA) is a large region on the medial surface of the frontal lobe of the brain, little is known about its function. The current study uses 3-tesla high-resolution diffusion tensor tractography (DTI) in healthy individuals and biotinylated dextran amine (BDA) and fluoro-gold (FG) tracer in rats to demonstrate the afferent and efferent connections of the SMA with brainstem structures. It also aims to clarify how SMA fibers relate to the corticospinal tract (CST). The BDA (n = 6) and FG (n = 8) tracers were pressure-injected into the SMA of 14 Wistar albino rats. Light and fluorescence microscopy was used to capture images of the FG and BDA-labeled cells and axons. High-resolution 3-tesla DTI data were acquired from the Human Connectome Project database. Tracts between the SMA and brainstem structures were analyzed using diffusion spectrum imaging (DSI) studio software. The FG injections into the SMA showed afferent projections from mesencephalic (periaqueductal gray matter, substantia nigra pars reticulata, ventral tegmental area, inferior colliculus, mesencephalic reticular, tegmental, and raphe nuclei), pontine (locus coeruleus, pontine reticular and vestibular nuclei), and medullary (area postrema, parabrachial, and medullary reticular nuclei) structures. The anterograde tracer BDA injections into the SMA showed efferent connections with mesencephalic (periaqueductal gray, substantia nigra pars compacta, dorsal raphe, trigeminal motor mesencephalic, and mesencephalic reticular nuclei), pontine (locus coeruleus, nucleus of the lateral lemniscus, vestibular, cochlear, and pontine reticular nuclei), and medullary (area postrema, medullary reticular, olivary, and parabrachial nuclei) structures. The SMA had efferent but no afferent connections with the cerebellar nuclei. The DTI results in healthy human subjects highly corresponded with the experimental results. Further, the DTI results showed a distinct bundle that descended to spinal levels closely related to the CST. Understanding SMA's afferent and efferent connections will enrich our knowledge of its contribution to various brainstem networks and may provide new perspectives for understanding its motor and non-motor functions.

Sex determination from glenoid cavity by computed tomography in Turkish population / Determinación del sexo de la cavidad glenoidea mediante tomografía computarizada en la población turca

SUMMARY: The aim of this study is to contribute to sex determination studies from the scapula in the Turkish population and compare with previous studies. This study was performed with 200 scapulae (100 males and 100 females). The age range of the patients was between 18-93 years old. Computed tomography scans were used and length of glenoid cavity (LGC), breadth of glenoid cavity (BGC), depth of glenoid cavity (DGC), perimeter (PM) and volume (VL) were measured. Randomly selected 20 scapulae were measured three times for examine the intra-rater reliability from those measurements. Gender logistic regression analysis was conducted to find the significant variables at sex determination from the scapula. The most effective parameter in determining sex from scapula was found to be VL (88.5%). The effects of LGC, PM, BGC and DGC at sex determination from scapula were found to be 83%, 82.5%, 79.5%, 66%, respectively. The combination of VL and PM (89.5%) was found to be the most effective combination at sex determination from the scapula. The intraclass correlation values of all measurements were found to be at high reliability. According to the literature, PM and DGC along with the VL in Turkish population, were not used previously for sex determination from the scapula. A combination of the VL and PM was found to be the most effective parameters at sex determination from scapula in the Turkish population. There are few studies on the sex determination from scapula in the Turkish population. This study will guide anthropologists, forensic scientists and anatomists at sex determination studies from scapula and surgeons by morphometrically in clinical situations related to the scapula.

RESUMEN: El objetivo de este estudio fue contribuir a la determinación del sexo a partir de la escápula en la población turca y comparar con estudios previos. Esta investigación se realizó con 200 escápulas (100 hombres y 100 mujeres). El rango de edad de los pacientes estaba entre de 18 años y 93 años. Escaner de tomografía computada se usó para medir en la cavidad glenoidea los siguientes parámetros: longitud (LCG), ancho (ACG), profundidad (PCG), perímetro (PG) y volumen (VCG). Se midieron 20 escápulas seleccionadas tres veces al azar para examinar la confiabilidad intraevaluador de estas mediciones. Se realizó un análisis de regresión logística de género para encontrar las variables significativas en la determinación del sexo a partir de la escápula. El parámetro más eficaz para determinar el sexo a partir de la escápula resultó ser VCG (88,5%). Los efectos de LCG, PG, ACG y PCG en la determinación del sexo a partir de la escápula fueron del 83 %, 82,5 %, 79,5 % y 66 %, respectivamente. La combinación de VCG y PG (89,5%) resultó ser la combinación más efectiva en la determinación del sexo a partir de la escápula. Se encontró que los valores de correlación intraclase de todas las mediciones tenían una alta confiabilidad. De acuerdo con la literatura, PG y PCG junto con el VCG en la población turca, no se han utilizado previamente para la determinación del sexo a partir de la escápula. Se determinó que una combinación de VCG y PG son los parámetros más efectivos en la determinación del sexo a partir de la escápula. Existe escasa información sobre la determinación del sexo a partir de la escápula en la población turca. Este estudio guiará a los antropólogos, forenses y anatomistas en los estudios de determinación del sexo de la escápula y sera útil para los cirujanos en situaciones clínicas relacionadas con la escápula.

Connections of the Dentate Nucleus with the Amygdala: Experimental Rat and Human 3-Tesla Tractography Study.

Background: The role of the cerebellum in motor function is well recognized. However, its role in higher nervous system activities such as cognition, emotion, endocrine, and autonomic activities is less known. The present study aims to show direct dento-amygdala projections using a biotinylated dextran amine (BDA) tracer in rats and 3-tesla (T) high-resolution diffusion tensor imaging (DTI)-based tractography in humans. Materials and Methods: The BDA tracer was pressure injected into the dentate nucleus of the cerebellum of Wistar albino rats. Labeled cells and axons were documented. High-resolution 3-T tractography data were obtained from the Human Connectome Project database. Dento-amygdala tracts were analyzed using diffusion spectrum imaging (DSI) Studio software. Results: The experimental study showed bilateral projections between the dentate nucleus and the central and basal nuclei and ipsilateral projections between lateral nuclei of the amygdala. The fibers from the dentate nucleus reached the amygdala through the superior cerebellar peduncle (SCP), and the contralateral fibers crossed in the decussation of SCP at the midbrain. The dento-amygdala results of the experimental study corresponded with the 3-T tractography findings on humans. Additionally, DTI findings showed that most of the dentate fibers passed through the hypothalamus before reaching the amygdala, and the amygdalae of the two sides are connected through the anterior commissure. Discussion: The 3-T DTI data of adult humans showed both direct dento-amygdala and indirect dento-hypothalamo-amygdala projections. Thus, this may indicate cerebellar contribution in modulation of emotional and autonomic functions. Furthermore, this can explain the emotional and cognitive deficits that occur in patients with cerebellar or SCP damage. Impact statement The present study showed direct dento-amygdala connections in the rat brain and human brain, which may provide evidence for cerebellar contribution in modulation of emotional and autonomic functions.