Assessment of the potential interactions between favipiravir and radiocontrast agents.

BACKGROUND: In cases of coronavirus disease 2019 (COVID-19), favipiravir is commonly included to the therapy regimen. Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched. However, no research on possible drug interactions between Favipiravir and radiocontrast agents, which have become almost crucial in diagnostic processes while not being part of the treatment, has been found. AIM: To determine potential medication interactions between Favipiravir and radiocontrast agents. METHODS: The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) test while taking the medicine. The computerized patient files of the cases included in the study, as well as the pharmacovigilance forms in the designated hospital, were evaluated for this purpose. RESULTS: The study included the evaluation of data from 1046 patients. The study sample's mean age was 47.23 ± 9.48 years. The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions (P = 0.003). When evaluated with logistic regression analysis, a 1-year raises in age increases the risk of developing drug interactions by 1.63 times (P = 0.023). There was no statistically significant difference in the occurrence of medication interactions between the sexes (P = 0.090). Possible medication interactions were discovered in 42 cases (4%). CONCLUSION: The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values, as well as an increase in the frequency of nausea and vomiting. The majority of drug interactions discovered were modest enough that they were not reflected in the clinic. Drug interactions become more common as people get older.

Shear Wave Ultrasonographic Elastography in Pediatric Spleens and Its Role in Differential Diagnosis.

Shear wave elastography (SWE) has become popular in clinical practice for many diseases. However, there is not adequate research on spleen-related diseases. This study aimed to investigate the potential of quantitative values obtained through SWE in evaluating spleen pathologies in the pediatric population and to demonstrate its performance to differentiate splenomegaly-related diseases. The research group retrospectively included children with pathological diagnoses related to the spleen from November 2016 to April 2021, and they were categorized into three groups, including portal hypertension (PH), benign lymphoid hyperplasia (BLH), and malignant infiltration (MI). Spleen sizes and parenchymal stiffness were also calculated for each group. Subsequently, mean spleen stiffness in each group was compared with normal values within the same age group. In total, 2781 children (1379 children for the study group; 1402 children for the control group) were enrolled in the study. The highest stiffness was observed in the PH group, which is statistically higher than others (p < 0.05). Although the mean spleen stiffness in the group with BLH was higher than the control and MI group, the difference was not statistically significant (p = 0.08). The mean stiffness in the group with MI was significantly lower than both the control group (p = 0.005) and PH (p = 0.01). In conclusion, using SWE in the differential diagnosis of etiologies causing splenomegaly could make an important contribution.

Normative measurements of orbital structures on magnetic resonance images; a cross-sectional study with mini review of the literature.

PURPOSE: Awareness of normative values of extra orbital structures would provide useful information to interpret the radiological images better and use them for diagnostic purposes. This study aimed to reveal the average values of major extraocular structures measured on magnetic resonance images. METHODS: In this retrospective cross-sectional study, magnetic resonance (MR) images of 256 orbits of 128 patients were re-interpreted regarding the measurements of major orbital structures. Extraocular muscles, superior ophthalmic vein, and optic nerve-sheath complex were measured on orbital MR images of these patients. The data distributions were presented by box-plot analyses for each parameter, and the measurement results were analyzed regarding gender and age groups. RESULTS: Lateral rectus muscle thickness (LR), inferior rectus muscle thickness (IR), globe position (GP), and interzygomatic line (IZL) values were higher in the male group than in the female group (p values were < 0.001, 0.003, 0.020, and < 0.001 respectively). LR, the thickness of the superior group muscles (SUP GR), IR, superior oblique muscle thickness (SOBL), and the thickness of optic nerve-sheath complex (ON) values indicated a significant relationship between age groups. There was a significant, positive, and low-level correlation between age and LR, SUP GR, and IR values (p values were < 0.001, 0.001, and < 0.001, respectively). CONCLUSION: This study provides quantitative data on normative values of orbital structures with gender and age group comparisons. Clinicians or surgeons can easily use the measured values to gather diagnostic information from the orbital region.

Incidental findings of cervical magnetic resonance imaging: A retrospective reinterpretation of a large adult population.

Background: Magnetic resonance imaging (MRI) of the cervical spine is one of the routine MRI scans of the cervical region in investigating spinal disc pathologies, spinal stenosis, and the detection of spinal lesions, which are the major parameters to be evaluated in this examination. Purpose: The authors of this study are focused on a different aspect of cervical MRI, revealing the incidences and reporting rates of extraspinal incidental findings. Methods: A total of 1000 patients (324 males, 676 females, mean age 47 ± 14) who had undergone an MRI of the cervical spine were enrolled in this study. The magnetic resonance (MR) images of these patients were re-interpreted with respect to the incidental extraspinal imaging findings. The incidence and reporting rate of each incidental finding encountered during the evaluation were presented in percentages. Results: 726 patients in this study had at least one incidental lesion. The results of this study revealed that the most common incidental lesions encountered during the reinterpretation of cervical MRI were nasopharyngeal mucosal thickening (n = 442) and thyroid hypertrophy (n = 231). The total reporting rate of incidental findings was 5.29%. Conclusion: There are many data to be reported and evaluated by MR imaging of the cervical spine, not only the main parameters of MRI scanning in the routine daily practice of radiologists. All our colleagues should be aware and careful of these incidental findings, which may be the initial medical data of the patients' diagnoses, or to avoid undesirable medicolegal problems.

AuNPs with Cynara scolymus leaf extracts rescue arsenic-induced neurobehavioral deficits and hippocampal tissue toxicity in Balb/c mice through D1R and D2R activation.

The present study was designed to evaluate whether AuNPs (gold nanoparticles) synthesized with the Cynara scolymus (CS) leaf exert protective and/or alleviative effects on arsenic (As)-induced hippocampal neurotoxicity in mice. Neurotoxicity in mice was developed by orally treating 10 mg/kg/day sodium arsenite (NaAsO2) for 21 days. 10 µg/g AuNPs, 1.6 g/kg CS, and 10 µg/g CS-AuNPs were administered orally simultaneously with 10 mg/kg As. CS and CS-AuNPs treatments showed down-regulation of TNF-α and IL-1ß levels. CS and CS-AuNPs also ameliorated apoptosis and reduced the alterations in the expression levels of D1 and D2 dopamine receptors induced by As. Simultaneous treatment with CS and CS-AuNPs improved As-induced learning, memory deficits, and motor coordination in mice assessed by water maze and locomotor tests, respectively. The results of this study provide evidence that CS-AuNPs demonstrated neuroprotective roles with antioxidant, anti-inflammatory, and anti-apoptotic effects, as well as improving D1 and D2 signaling, and eventually reversed neurobehavioral impairments.

Association between the most superior point of patella-entrance of femoral trochlea distance ratio (SP-ET index) and chondromalacia patella: an investigation via magnetic resonance imaging.

Purpose: In this study, the effect of the most superior point of patella-entrance of femoral trochlea distance ratio (SP-ET index) on chondromalacia patella (CP) was investigated with 2 reviewers. Material and methods: A total of 348 knees of 308 patients were analysed retrospectively with magnetic resonance imaging (MRI). Patients with or without CP constituted the study and the control groups in this cross-sectional investigation. Two reviewers interpreted the dataset regarding the SP-ET index. This ratio was calculated as the distance between the most superior point of patella and the entrance of femoral trochlea (ß) divided by the patellar articular surface length (α). The relationship between the SP-ET index and CP was presented using independent samples T-tests, and the intraclass correlation coefficient (ICC) was calculated to reveal the interobserver differences. Results: There was excellent agreement between the reviewers regarding α, ß, and SP-ET values (ICC was 0.971, 0.964, and 0.943, respectively). Higher SP-ET values were obtained for patients with CP, in comparison with patients without any chondral lesion (p < 0.001). A significant, positive, and moderate level of correlation was revealed between SP-ET measurements and CP grades for the total study population. Conclusions: SP-ET index showed high interobserver agreement and indicated a significant difference between patients with and without CP. Both reviewers' results indicated positive and significant correlation between the measured SP-ET values and different grades of CP for females, males, and the total study population.

The 2D and 3D MR arthrographic description of aponeurotic expansion of supraspinatus tendon and biceps tendon anomaly in a large patient cohort.

OBJECTIVE: To describe the aponeurotic expansion of supraspinatus tendon (AEST) and biceps tendon abnormalities with magnetic resonance (MR) arthrographic examinations and determine their prevalence in patients, we performed a high-resolution 3D direct MR arthrography. MATERIALS AND METHODS: This was a retrospective study of 700 shoulder MR arthrograms performed between May 2010 and January 2022. Extension in the coronal plane of an AEST on 3D fat-suppressed T1-weighted volumetric interpolated breath-hold examination (VIBE) MR arthrography was identified. Based on its morphology, the AEST on MR arthrography was divided into four subtypes: absence of tendinous thickness in the bicipital synovial surface or intra-synovial tendon-like structure in the bicipital groove, thin and flat tendinous thickness ≥1 mm of bicipital synovium, oval tendinous structure less than half the size of the adjacent biceps tendon, oval tendinous structure more than half the size of the adjacent biceps tendon, and oval tendinous structure larger than the adjacent biceps tendon. Based on its origin and termination, aponeurotic expansions can be divided into three subtypes: proximal pulley zone, middle humeral neck zone, and distal myotendinous junction zone. Association with the biceps synovium of the AEST was categorized into three types: intra-synovial, extra-synovial, and trans-synovial. RESULTS: An AEST in the anterior shoulder joint in 3D VIBE MR arthrography images was identified in 63 (9%) of 700 arthrograms. The most common arthrographic type of AEST was type 1-this was detected in 39 of 63 patients. The most common course type of the AEST was anteriorly midline. The most common distal insertion type was at the tenosynovial sheath of the long head of the biceps tendon (LHBT) in the middle humeral neck zone-this was detected in 31 of 63 patients. There were only 10 MR arthrograms biceps tendon abnormality, including 4 biceps agenesis and 6 split ruptures. CONCLUSION: A 2D and high-resolution 3D MR arthrography can demonstrate the anatomical detail around the bicipital groove and facilitate the differentiation between a biceps tendon anomaly and an AEST. On high-resolution 3D MR arthrographic images, the AEST tends to be in the anterior midline and anteromedial portions of the biceps synovium with intra-synovial, extra-synovial, and trans-synovial courses and its three different insertion types.

Examination of ethmoidal roof regarding Keros and Yenigun classifications in a Turkish population: a computerized tomography study.

PURPOSE: Understanding ethmoid roof morphology is crucial to prevent complications in endoscopic sinus surgery. This study aimed to evaluate the morphological properties of the ethmoidal roof regarding gender and age differences using Keros and Yenigun classifications on high-resolution computed tomography images. METHODS: We retrospectively analyzed 891 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in coronal sections and the anterior-posterior length in axial planes. The study retrospectively examined CT images of paranasal sinuses of patients living in the eastern Anatolian region of Turkey. RESULTS: In both Keros and Yenigun Classifications, the most common class was type 2, and the least common class was type 3. According to Keros et al.'s method, no significant difference was observed between men and women (p = 0.698). However, according to Yenigun et al., the average values of women in terms of the anterior-posterior distance of the ethmoid roof were significantly higher than men (p = 0.001). When examined according to age, a very low, negative correlation was revealed regarding Keros and Yenigun classifications (p = 0.047 and p < 0.001 retrospectively). According to Keros and Yenigun's classification, there was no significant difference between the left and right sides (p = 0.488 and p = 0.919, respectively). CONCLUSION: The morphological properties of the ethmoidal roof have importance to be considered for preoperative planning. Studying larger patient groups and meta-analyses that gather various research results about this subject might help better understand the ethmoidal roof morphology among populations.

Earthquakes from a radiological perspective: what is demanded from the radiologists, and what can we do? A pictorial review.

Earthquakes are among the most destructive and unpredictable natural disasters. Various diseases and ailments, such as bone fractures, organ and soft-tissue injuries, cardiovascular diseases, lung diseases, and infectious diseases, can develop in the aftermath of severe earthquakes. Digital radiography, ultrasound, computed tomography, and magnetic resonance imaging are significant imaging modalities utilized for the quick and reliable assessment of earthquake-related ailments to facilitate the planning of suitable therapy. This article examines the usual radiological imaging characteristics observed in individuals from quake-damaged regions and summarizes the strengths and functionality of imaging modalities. In such circumstances, where quick decision-making processes are life-saving and essential, we hope this review will be a practical reference for readers.

Does the use of computed tomography scenogram alone enable diagnosis in cases of bowel obstruction?

BACKGROUND: Ileus is a pathological condition of the abdomen that presents as a medical emergency. It is characterized by potential complications such as perforation and ischemia, which can lead to significant morbidity and mortality if not promptly addressed. The successful management of ileus relies heavily on the timely and precise identification of the condition. While conventional radiography (CR) is commonly used as the primary diagnostic tool, its accuracy in identifying obstructions ranges from 46% to 80%. Furthermore, the diagnostic accuracy of identifying the location and etiology of intestinal obstruction by CR is limited, therefore making computed tomography (CT) the ideal imaging modality in this regard. AIM: To determine the presence of acute bowel obstruction (BO) on abdominal CT scenogram images and the accuracy of determining its possible location, taking into account the experience of the observers. METHODS: A retrospective screening was conducted on an ensemble of 46 individuals who presented to the emergency department between January 2021 and January 2022 with severe abdominal pain and were subsequently monitored for suspected ileus. The abdominal CT scans of these patients were assessed by three radiologists with varying levels of experience (1, 3, and 10 years) at different intervals (1 mo apart). The evaluation focused on determining the presence or absence of BO, as well as identifying the potential location of the obstruction (small bowel or large bowel). The study employed Kappa statistics to assess inter-observer variances, while the McNamer test was used to evaluate obstruction and segmentation discrepancies between observations. A significance level of P < 0.05 was determined to indicate statistical significance. RESULTS: Out of the total sample size of 46 patients, 15 individuals (32.6%) were identified as female, while the remaining 31 individuals (67.4%) were identified as male. The ultimate diagnosis of 42 instances (91.3%) indicated ileus resulting from mechanical obstruction (MO). Among these patients, 14 (33%) experienced obstruction in the large bowel (LB), while 28 (66%) experienced obstruction in the small bowel (SB). The initial evaluation yielded sensitivity rates of 76.19%, 83.31%, and 83.33%, and diagnostic accuracy rates of 69.56%, 76.08%, and 80.43% for the detection of BO among the three observers. The initial study revealed that the average sensitivity of three observers in detecting the presence of ileus caused by MO was 80.94%, while the diagnostic accuracy was 75.35%. Based on the first evaluation, the senior observer demonstrated the highest sensitivity (85.71%), negative predictive value (92.60%), and diagnostic accuracy (80.43%) when accurately estimating the thick and thin segmentation, as per the final diagnosis. There was no statistically significant disparity observed in the sensitivities pertaining to the identification of ileus during the second assessment, as well as the precise determination of the segment level inside the LB or SB, when comparing the second and third observers. Nevertheless, although there was no statistically significant alteration in the detection rate of ileus by the first observer, there was a notable rise in the accuracy rate of segment estimating (73.91%). The senior assessor had a higher level of accuracy in assessing the existence of ileus and segmentation compared to the other evaluators in both evaluations. CONCLUSION: The findings of our study indicate that the sensitivity and accuracy rates of abdominal CT scenogram scans in diagnosing acute MOs are similar to or greater than those of CR. Additionally, the study revealed that radiologists with more experience demonstrated a higher likelihood of accurately predicting the existence and potential localization of MO compared to their less experienced counterparts.

Shear-wave Elastography of Palatine Tonsils: A Normative Study in Children.

Background: Shear-wave elastography (SWE) was used to determine normal elasticity values of palatine tonsils (PTs) in children and adolescents who did not have any health problem, and the relationship between these values and various parameters influencing this result was examined. Methods: The current prospective study has been approved by the local Institutional Review Board. Our study included 122 people aged 2-18 years. SWE values for both PTs, as well as gender, age, and body mass index (BMI), were recorded. The Kolmogorov-Smirnov test was used to determine whether the data had a normal distribution. Numerical variables with a normal distribution are reported as mean ± standard deviation, while variables with a nonnormal distribution are reported as medians with minimum and maximum values. Numbers and percentages are used to report categorical variables. Results: The study group's average age was 10.77 ± 4.35 years. The mean SWE values were 9.89 ± 2.494 kPa for the right PT and 9.57 ± 2.631 kPa for the left PT. Both PT volumes were found to be 1.6 ± 0.9 mm3. There was no significant correlation between the SWE values obtained and age, height, weight, and BMI. Tonsil dimensions show a positive correlation with age, height, weight, and BMI. Conclusion: PT dimensions have a positive correlation with age, height, weight, and BMI, but not with SWE values. SWE may be a reliable diagnostic criterion independent of anthropometric values.

Quadruple-Rule-Out Computed Tomography Angiography (QRO-CT): A Novel Dual-Energy Computed Tomography Technique for the Diagnostic Work-Up of Acute Chest Pain.

BACKGROUND: Computerized tomography (CT) has been increasingly utilized in the differential diagnosis of acute chest pain. Combining the triple rule out CT angiography (TRO-CT) approach with dual-energy CT (DECT) can enhance the diagnostic capability by identifying myocardial perfusion deficiencies. This combination can yield a quadruple-rule-out computed tomography angiography (QRO-CT) technique. The aim of this study is to determine the efficacy of the QRO-CT. METHODS: Intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. The myocardial dark spots on the color-coded iodine map were identified as perfusion deficiencies. Pulmonary arteries and aorta were also evaluated. RESULTS: The study population consisted of 211 patients. The sensitivity, specificity, and positive and negative predictive values of QRO-CT for pulmonary embolism were 93.5%, 100%, 100%, and 95.3%, respectively. For obstructive coronary artery disease, the values were 96.1%, 93.4%, 89.2%, and 97.7%, respectively. For myocarditis, the values were 69.2%, 100%, 100%, and 93.6%, respectively. CONCLUSIONS: the QRO-CT method may successfully evaluate myocardial perfusion deficits, hence expanding the differential diagnosis capabilities of the standard TRO-CT method for myocarditis. It can provide useful information on myocardial perfusion, which may influence the choice to perform invasive catheterization in cases of coronary artery obstruction.

Anomalous origin of the temporopolar artery from the internal carotid artery and aneurysms at the temporopolar and internal carotid arteries: a very rare case report.

The temporopolar artery (TPA) originates directly from the sphenoidal segment of the middle cerebral artery (MCA). Its originating from the M1 segment of the MCA as a branch of the anterior temporal artery is not uncommon. However, internal carotid artery origination is a very rare variation of the TPA. Here, we report a very rare case of the variant origin of the TPA and the presence of saccular aneurysm at this origin.