Diagnostic and Imaging Findings in Inflammatory Opacifications of the Middle Ear: A Review of the Literature.

Opacification in the middle ear and mastoid region can stem from a wide range of factors. In terms of diagnostic imaging, CT is the primary tool due to its exceptional spatial resolution, particularly for examining the temporal bone and ossicles. MRI complements this by offering detailed soft tissue lesion characterization and assessing involvement in the inner ear and cranial nerves. This study focuses on inflammatory causes of opacification in the middle ear and mastoid, with an emphasis on the utility of CT and MRI. This comprehensive review aimed to provide a practical framework for considering potential differential diagnoses.

Dynamic Flexion-Extension Magnetic Resonance Imaging of the Cervical Spine: An Evolutionary Tool for Diagnosis and Management of Cervical Spondylotic Myelopathy.

Dynamic problems need dynamic solutions. High motility of the cervical spine causes a common age-related degenerative condition called cervical spondylotic myelopathy (CSM), manifested by neurological impairments. An accurate and reliable diagnosis of CSM is crucial for determining appropriate management strategies. Traditional static magnetic resonance imaging (MRI) has been the gold standard for imaging CSM; however, it may not fully capture dynamic changes during neck movement. Dynamic flexion-extension (DFE) MRI is an innovative imaging technique that allows for real-time visualization of cervical spine motion. This review article aims to scrutinize the role of DFE MRI in assessing CSM, its added value to clinical implementations, and its limitations. Finally, by addressing the knowledge gaps, this survey sheds light on the road ahead to incorporate DFE MRI into a standard version of the practice.

Intra-prostatic gold fiducial marker insertion for image-guided radiotherapy (IGRT): five-year experience on 795 patients.

INTRODUCTION: Prostate cancer is the second most commonly diagnosed cancer in males. The use of intra-prostatic fiducial markers (FM) for image-guided radiotherapy (IGRT) has become widespread due to their accuracy, relatively safe use, low cost, and reproducibility. FM provides a tool to monitor prostate position and volume changes. Many studies reported low to moderate rates of complications following FM implantation. In the current study, we present our five years' experience regarding the insertion technique, technical success, and rates of complication and migration of intraprostatic insertion of FM gold marker. METHODS: From January 2018 to January 2023, 795 patients with prostate cancer candidate for IGRT (with or without a history of radical prostatectomy) enrolled in this study. We used three fiducial markers (3*0.6 mm) inserted through an 18-gauge Chiba needle under transrectal ultrasonography (TRUS) guidance. The patients were observed for complications up to seven days after the procedure. Besides, the rate of marker migration was recorded. RESULTS: All procedures were completed successfully, and all patients tolerated the procedure well with minimal discomfort. The rate of sepsis after the procedure was 1%, and transient urinary obstruction was 1.6%. Only two patients experienced marker migration shortly after insertion, and no fiducial migration was reported throughout radiotherapy. No other major complication was recorded. DISCUSSION: TRUS-guided intraprostatic FM implantation is technically feasible, safe, and well-tolerated in most patients. The FM migration can seldom occur, with negligible effects. This study can provide convincing evidence that TRUS-guided intra-prostatic FM insertion is an appropriate choice for IGRT.

Risk factors of osteoporosis and osteopenia in postmenopausal women based on the L2-L4 BMD T score of the lumbar spine: a study in Iran.

OBJECTIVE: To determine the risk factors of osteoporosis and osteopenia of the spine in postmenopausal women. METHOD: An analytical cross-sectional study was performed on postmenopausal women. The T-score of the lumbar spine (L2-L4) was measured by densitometry and compared between osteoporotic, osteopenia, and normal women. RESULTS: One thousand three hundred fify-nine postmenopausal women were evaluated. The prevalence of osteopenia and osteoporosis was 58.2% and 12.8% respectively. Age, BMI, parity, total breastfeeding years, dairy use, calcium-D supplements, and regular exercise were significantly different in women with osteoporosis, osteopenia, and normal women. Ethnicity, diabetes, and previous fracture history were only other among women with osteoporosis (not osteopenia) and normal women. For osteopenia of the spine, age [AOR 1.08 (1.05-1.11; p < .001)] was the risk factor, and BMI = >30 [AOR 0.36 (0.28-0.58; p < .001)] and BMI 25-<30 [AOR 0.55 (0.34-0.88; p = .012)] were protective factors. Hyperthyroidism (AOR 23.43, p = .010), Kurdish ethnicity (AOR 2.96, p = .009), not having regular exercise (AOR 2.22, p = .012), previous fracture history (AOR 2.15, p = .041)], and age (AOR 1.14, p < .001)], were risk factors for osteoporosis, while BMI ≥30 [AOR 0.09, p < .001], BMI 25-<30 [AOR 0.28, p = .001], and diabetes [AOR 0.41, p = .038] were protective factors for osteoporosis of the spine. CONCLUSION: Hyperthyroidism, low BMI <25, parity ≥ 6, Kurdish ethnicity, not having regular exercise, history of previous fracture, and age, were risk factors for osteoporosis of the spine respectively, while low BMI and age were risk factors for osteopenia.

Studying the effect of donor kidney volume ratios to recipients' body surface area, body mass index, and total body weight on post-transplant graft function.

OBJECTIVES: The goal of this study was to retrospectively investigate the relationship between renal transplanted volume indexes (Total kidney volume (TKV)/Body surface area (BSA), Renal parenchymal volume (RPV)/BSA, Renal cortical volume (RCV)/BSA, RPV/Body mass index (BMI), RCV/BMI, RPV/Weight, RCV/Weight), and short- and long-term function of the graft. METHODS: One-hundred and twelve live donor-recipient pairs from 2017 to 2018, whose donors underwent preoperative renal computed tomography angiography and recipients survived during 12 months of follow-up, were included in this study. RESULTS: The crude and adjusted linear regressions for the effect of volume measurements by voxel and ellipsoid methods on the estimated glomerular filtration rate (eGFR) at different post-transplantation times demonstrated that the RPV/weight ratio had the most substantial crude effect on the eGFR 12 months and 4 years after renal transplant. Receiver operating characteristic (ROC) curves for six different renal volume ratios demonstrated no significant difference between these ratios in terms of discriminative ability (p value < 0.05). A strong direct correlation between TKV calculated by the ellipsoid formula with RPV and RCV measured using OsiriX software was noted. Analysis of ROC curves for renal volume indices has demonstrated fair to good discriminative ability of our cut-off points to estimate 4-year post-transplantation eGFR > 60 mL/min. CONCLUSION: Renal transplant recipients' volume indices, such as RPV/weight, had strong correlations with eGFR at different points in time, and renal transplant recipients with the volume ratios higher than our cut-off points had a good chance of having a 4-year post-transplantation eGFR higher than 60 mL/min.

The psychotomimetic ketamine disrupts the transfer of late sensory information in the corticothalamic network.

In prodromal and early schizophrenia, disorders of attention and perception are associated with structural and chemical brain abnormalities and with dysfunctional corticothalamic networks exhibiting disturbed brain rhythms. The underlying mechanisms are elusive. The non-competitive NMDA receptor antagonist ketamine simulates the symptoms of prodromal and early schizophrenia, including disturbances in ongoing and task & sensory-related broadband beta-/gamma-frequency (17-29 Hz/30-80 Hz) oscillations in corticothalamic networks. In normal healthy subjects and rodents, complex integration processes, like sensory perception, induce transient, large-scale synchronised beta/gamma oscillations in a time window of a few hundred ms (200-700 ms) after the presentation of the object of attention (e.g., sensory stimulation). Our goal was to use an electrophysiological multisite network approach to investigate, in lightly anesthetised rats, the effects of a single psychotomimetic dose (2.5 mg/kg, subcutaneous) of ketamine on sensory stimulus-induced oscillations. Ketamine transiently increased the power of baseline beta/gamma oscillations and decreased sensory-induced beta/gamma oscillations. In addition, it disrupted information transferability in both the somatosensory thalamus and the related cortex and decreased the sensory-induced thalamocortical connectivity in the broadband gamma range. The present findings support the hypothesis that NMDA receptor antagonism disrupts the transfer of perceptual information in the somatosensory cortico-thalamo-cortical system.

TMM-Fast, a transfer matrix computation package for multilayer thin-film optimization: tutorial.

Achieving the desired optical response from a multilayer thin-film structure over a broad range of wavelengths and angles of incidence can be challenging. An advanced thin-film structure can consist of multiple materials with different thicknesses and numerous layers. Design and optimization of complex thin-film structures with multiple variables is a computationally heavy problem that is still under active research. To enable fast and easy experimentation with new optimization techniques, we propose the Python package Transfer Matrix Method - Fast (TMM-Fast), which enables parallelized computation of reflection and transmission of light at different angles of incidence and wavelengths through the multilayer thin film. By decreasing computational time, generating datasets for machine learning becomes feasible, and evolutionary optimization can be used effectively. Additionally, the subpackage TMM-Torch allows us to directly compute analytical gradients for local optimization by using PyTorch Autograd functionality. Finally, an OpenAI Gym environment is presented, which allows the user to train new reinforcement learning agents on the problem of finding multilayer thin-film configurations.

The return visit, outcome and predicting factors of return visit among suspected COVID-19 outpatients.

Rate of return visit, predicting factors of return visit and occurrence of adverse events in suspected to be or likely cases of COVID-19 patients who received outpatient treatment. This is a retrospective observational cohort study on patients (> 16 years), suspected to be or likely cases of COVID-19 who were visited in a respiratory emergency department and subsequently discharged home. Patients' baseline characteristics were extracted from medical charts. All patients were followed-up for 7 days after their first visit. Patients' outcomes during the7-day follow-up, as well as the severity of pulmonary involvement based on imaging were recorded. A total number of 601 patients (350 men and 251 women) were recruited. The rate of return visit was 27.74% (144 patients) with 6.74% (34 patients) experiencing a poor outcome. Six factors with a significant odds ratio were predictors of poor outcome in patients who received outpatient treatment, namely, older age [odds ratio = 3.278, 95% confidence interval: 1.115-9.632], days from onset of symptoms [1.068, 1.003-1.137], and history of diabetes [6.373, 2.271-17.883]). Predictors of favorable outcome were female gender [0.376, 0.158-0.894], oxygen saturation > 93% [0.862, 0.733-1.014], smoking habit [0.204, 0.045-0.934]. The findings of this study demonstrate that the rate of return visit with poor outcome in patients who received outpatient treatment was reasonably low. Age, male sex, diabetes mellitus and pulmonary disease are predicting factors of poor outcome in these COVID-19 patients who received outpatient management.

Hydrological components of groundwater recharge in leaky aquifers adjacent to semipervious streambank: analytical study.

Groundwater resources can be artificially augmented by managed aquifer recharge especially in arid and semi-arid areas. Unlike most of the existing results which focus only on impervious aquifer base and assume perfect hydraulic connection between aquifer and adjacent stream, the present study addresses the recharge process in a more realistic case of leaky aquifer interacting with semipervious streambank. The mathematical model relies on 2D linearized Boussinesq equation with Robin boundary condition accounting for hydraulic resistance owing to semiperviousness of the streambed. The method of Green's function offers an integral representation of hydraulic head in semi-infinite aquifer domain in response to time-varying recharge from a rectangular basin. Hydrological components of groundwater recharge are derived taking into account volumetric rates of leakage, mound storage, and outflow to adjacent stream. Hypothetical test cases illustrate how sum of these components exactly counterbalances the volumetric rate of recharge received by the aquifer at each instant of time, and this is in full conformity with the expected mass balance at aquifer scale. The most influential parameters affecting the model outputs are identified through sensitivity analysis. Furthermore, interaction of pumping wells with groundwater mound is examined. Performance of the present results is assessed against numerical counterparts from finite element method, and extremely good agreement is found for temporal mound peaks.

Carotid intima-media and epicardial adipose tissue thickness in adult patients with epilepsy taking anti-seizure medication and its long-term significance.

OBJECTIVES: We investigated epicardial adipose tissue thickness (EATT), carotid intima-media thickness (CIMT), and lipid profile in adult patients with epilepsy (PWE) taking anti-seizure medication(s) (ASM) and compared with those of the healthy population. We also investigated whether duration of follow-up and number of ASM(s) (mono- vs. polytherapy) affect these risk factors. METHODS: Twenty PWE older than 18 years of age were recruited at the outpatient epilepsy clinic and compared to twenty controls. Patients who were 18 years old and younger, those with cardiovascular risk factors, and patients with follow-up duration less than 2 years were excluded from the study. RESULTS: Epicardial adipose tissue thickness and CIMT were thicker compared to controls. While patients' low-density lipoprotein (LDL) levels were higher than controls, and high-density lipoprotein (HDL) levels were lower, the levels were in normal ranges. Those patients with duration of follow-up more than five years had thicker EATT. The 5-year LDL was in normal ranges while HDL was abnormally low. Number of ASM(s) was not associated with increased risks of atherosclerosis. Increased CIMT in patients taking ASM(s) was independent of their lipid profile. CONCLUSION: Anti-seizure medications contribute to accelerated atherosclerosis in people with epilepsy. Chronic use of ASMs may increase this chance. It is appropriate to use ASM(s) with lower chances of atherosclerosis in people with epilepsy and encourage them to change their lifestyle in order to modify cardiovascular risk factors. Meantime, it is reasonable to assess the risk of atherosclerosis periodically in these patients by noninvasive methods including lipid profile, CIMT, and EATT.

Correlation Between Low-Dose Chest Computed Tomography and RT-PCR Results for the Diagnosis of COVID-19: A Report of 27,824 Cases in Tehran, Iran.

RATIONALE AND OBJECTIVES: Real-time polymerase chain reaction (RT-PCR) remains the gold standard for confirmation of Coronavirus Disease 2019 (COVID-19) despite having many disadvantages. Here, we investigated the diagnostic performance of chest computed tomography (CT) as an alternative to RT-PCR in patients with clinical suspicion of COVID-19 infection. METHODS: In this descriptive cross-sectional study, 27,824 patients with clinical suspicion of COVID-19 infection who underwent unenhanced low-dose chest CT from 20 February, 2020 to 21 May, 2020 were evaluated. Patients were recruited from seven specifically designated hospitals for patients with COVID-19 infection affiliated to Shahid Beheshti University of Medical Sciences. In each hospital, images were interpreted by two independent radiologists. CT findings were considered as positive/negative for COVID-19 infection based on RSNA diagnostic criteria. Then, the correlation between the number of daily positive chest CT scans and number of daily PCR-confirmed cases and COVID-19-related deaths in Tehran province during this three-month period was assessed. The trends of admission rate and patients with positive CT scans were also evaluated. RESULTS: A strong positive correlation between the numbers of daily positive CT scans and daily PCR-confirmed COVID-19 cases (r = 0.913, p < 0.001) was observed. Furthermore, in hospitals located in regions with a lower socioeconomic status, the admission rate and number of positive cases within this three-month period was higher as compared to other hospitals. CONCLUSION: Low-dose chest CT is a safe, rapid and reliable alternative to RT-PCR for the diagnosis of COVID-19 in high-prevalence regions. In addition, our study provides further evidence for considering patients' socioeconomic status as an important risk factor for COVID-19.

Well-controlled vs poorly-controlled diabetes in patients with COVID-19: Are there any differences in outcomes and imaging findings?

AIMS: We aimed to compare the clinical outcomes and imaging findings between COVID-19 patients with well-controlled diabetes and those with poorly-controlled diabetes. METHODS: In this retrospective single-center study, 117 patients with coexistent COVID-19 and type 2 diabetes mellitus were included. Patients were divided into two groups based on HbA1c values. Clinical data and laboratory parameters were collected from patients' medical records. Also, the chest computed tomography (CT) score was defined by the summation of individual scores from 5 lung lobes: scores of 0, 1, 2, 3, 4 and 5 were respectively assigned for each lobe if pulmonary involvement was 0%, less than 5%, 5%-25%, 26%-49%, 50%-75%, or more than 75% of each region. RESULTS: Among all patients with diabetes, 93 (79.5%) patients had poorly-controlled diabetes and 24 (20.5%) had well-controlled diabetes; 66 (56.4%) patients were male and the median age was 66 years (IQR, 55-75 years). The chest CT severity scores were not significantly different between patients with well-controlled diabetes and those with poorly-controlled diabetes (p = 0.33). Also, the mortality and recovery rates were similar between the two groups (p = 0.54 and p = 0.85, respectively). CONCLUSION: Based on the results, clinical outcomes and chest CT severity scores are similar between patients with well-controlled and poorly-controlled diabetes among the Iranian population with COVID-19.

Effects of inclusion of corn gluten feed in dairy rations on dry matter intake, milk yield, milk components, and ruminal fermentation parameters: a meta-analysis.

Corn gluten feed (CGF) is a co-product of wet milling that can replace energy or fiber ingredients in dairy cow rations. The present meta-analysis examines how inclusion of CGF can affect dry matter intake (DMI), milk yield (MY), milk components, and ruminal fermentation parameters. A literature search was conducted to identify papers published from 1990 to 2018. Effect size for all parameters was calculated as standardized mean difference with a 95% confidence interval. Heterogeneity was determined using Q test and I2 statistic, while meta-regression was used to examine factors influencing heterogeneity. Results indicate that feeding CGF increased the effect size for DMI and MY. No differences were observed for effect size for percentage milk fat or protein; however, increases were observed in the effect size for milk fat yield, milk protein yield, milk lactose percentage, and milk lactose yield. Ruminal fermentation parameters revealed a decrease in the effect size for pH and acetate and an increase for propionate. No differences were observed in the effect size for total VFA or butyrate. The Q test demonstrated heterogeneity (P < 0.1) for MY, MFP, and pH. The results indicate differences in forage intake between groups receiving CGF and control as an important factor contributing to heterogeneity for DMI, MFP, and pH. It can be concluded from this meta-analysis that in addition to increased DMI, inclusion of CGF in cow diets increases MY and improves milk components. Furthermore, inclusion of CGF in the diet lowers ruminal pH while decreasing acetate and increasing propionate contents.

Environmental efficiency of Saccharomyces cerevisiae on methane production in dairy and beef cattle via a meta-analysis.

The objective of the present study is to examine the effect of yeast (Saccharomyces cerevisiae) on reduction of methane (CH4) production in dairy and beef cattle using meta-analytic methods. After compilation of relevant scientific publications available from the literature between 1990 and 2016, and applying exclusion and inclusion criteria, meta-analyses of data from dairy and beef cattle were applied for the pooled dataset or for each animal category (dairy or beef). The results of meta-analysis of all three datasets (all cattle, dairy cattle, or beef cattle) suggested that effect size of yeast either on daily CH4 production or on CH4 production per dry matter intake (CH4/DMI) was not significant. The results of Q test and I2 statistic suggest that there is no heterogeneity between different studies on CH4 production and CH4/DMI. The results of meta-analysis suggest that use of yeast (Saccharomyces cerevisiae) as feed additive does not offer significant results in terms of reduction of CH4 production in dairy and beef cattle. Further research on the effects of different doses of yeast, use of yeast products, different strains, and experimental designs is warranted to elucidate the effects of yeasts on methane production in the rumen.

Comparative restriction enzyme mapping of Campylobacter jejuni isolates from turkeys and broilers based on flaA flagellar gene using HpyF3I endonuclease.

Turkeys and broilers have been identified as important reservoirs for Campylobacter jejuni which is of public health significance. The evaluation of the genotypes among C. jejuni strains within different reservoirs is critical for our understanding of the epidemiology of this infectious agent. The present study aimed to compare the genetic diversity and differences of C. jejuni isolates from turkeys and broilers using flagellin PCR-RFLP typing (flaA typing) technique, in terms of the ease of use and discriminatory power. Sixty C. jejuni isolates were detected biochemically and confirmed by duplex-PCR from turkeys and broilers (30 strains from each bird species). Then, a flaA gene fragment (1725 bp) of C. jejuni isolates was amplified and amplicons were digested with HpyF3I enzyme. Restriction analysis by HpyF3I gave four different flaA patterns (H1, H2, H3, H4) among all tested C. jejuni isolates. In broiler isolates, all four patterns were observed but in turkey isolates, only H2 and H4 patterns were present. The results clearly demonstrated that distribution of the flaA typing patterns differed depending on the host species (broiler/turkey). H1 and H3 flaA types are more prevalent in broiler than turkey isolates, while H2 type is significantly more prevalent within isolates from turkey (p < 0.05). The flaA typing technique by digestion with HpyF3I enzyme can almost give us a clue to the source of infection in local outbreaks.

Natural History of Medulloblastoma in a Child with Neurofibromatosis Type I.

Medulloblastoma is one of the common posterior fossa tumors in children. The natural history of this tumor in presymptomatic period is not well known. Widespread use of brain imaging has increased the detection of incidental brain tumors in totally asymptomatic persons. Here, we report a case of a 4-year-old boy with prenatal diagnosis of congenital brain abnormalities and neurofibromatosis type I. He underwent regular brain imaging to follow interhemispheric arachnoid cyst and ventriculomegaly that a posterior fossa tumor was discovered. The tumor size increased during time and became symptomatic after 28 months which was resected.

Data for zonisamide effect on length and weight of 14 day-old rat pups and abortion rate and day in refractory epileptic pregnant rats.

Length and weight of 14 day-old rat pups and also abortion rate and day on refractory epileptic pregnant rats after treatment with zonisamide (ZNS) are presented. Lamotrigine-resistant chemical kindling procedure was used for inducing of refractory epilepsy. For further interpretation follow the research article: Effect of zonisamide on refractory epilepsy during pregnancy in lamotrigine resistant kindled rats (Sani et al., 2017) [1].