Volumetric magnetic resonance imaging differences between complex febrile seizure and recurrent simple febrile seizure.

PURPOSE: We investigated the volumetric differences in cortical and subcortical structures between patients with complex febrile seizure (FS) and recurrent simple FS. We aimed to identify the brain morphological patterns of children with complex FS. METHODS: Twenty-five patients with complex FS and age- and sex-matched 25 patients with recurrent simple FS with structural magnetic resonance imaging (MRI) scans were studied. Cortical volumetric analysis was performed using a voxel-based morphometry method with the CAT12 toolbox within SPM12. FSL-FIRST was used to obtain volume measures of subcortical deep grey matter structures (amygdala, caudate nucleus, thalamus, nucleus accumbens, putamen, globus pallidus, and hippocampus). The volumetric asymmetry index (AI) and laterality index (LI) were calculated for each subcortical structure. RESULTS: Compared with recurrent simple FS, complex FS demonstrated lower volume in the left putamen (p = .003) and right nucleus accumbens (p = .001). Additionally, patients with complex FS presented a higher magnitude of AI of the nucleus accumbens (p < .001) compared with recurrent simple FS. CONCLUSIONS: The findings indicate that volumetric analysis may be a useful marker for the detection of FS-induced changes that reflect microstructural alterations. This study is the first to report on alterations in the putamen and nucleus accumbens in FS.

Use of phase-contrast MRI to measure aortic stiffness in young-onset hypertension: a pilot study.

BACKGROUND: Young-onset hypertension is defined as hypertension diagnosed before the age of 40 years. Aortic pulse wave velocity is an indication of aortic stiffness. MRI assessment has been well verified compared to invasive pressure recordings for evaluating aortic pulse wave velocity. In this study, we aimed to determine whether aortic stiffness played a role in the aetiology of young-onset hypertension by calculating pulse wave velocity using MRI. METHODS: We enrolled 20 patients diagnosed with young-onset hypertension and 20 volunteers without hypertension. Aortic pulse wave velocity was measured by cardiac MRI and protocol for the pulse wave velocity measurement involved the use of a 1.5 T scanner to acquire velocity-encoded, phase-contrast transverse aortic cine images. Sagittal oblique images used to measure the distance (ΔX) between the ascending aorta and descending aorta for the calculation of pulse wave velocity. The aortic flow versus time curves of ascending aorta and descending aorta were automatically obtained from the phase-contrast MRI images. Using these curves, the temporal shift (ΔT) was measured by Segment Medviso. FINDINGS: The mean pulse wave velocity was 8.72 (SD 2.34) m/second (range: 7-12.8 m/second) for the patient group and 5.96 (standard deviation 1.86) m/second (range: 4.8-7.1 m/second) for the control group. The pulse wave velocity values were significantly higher in the patient group compared to the control group (p < 0.001). INTERPRETATION: Aortic stiffness may play a role in the aetiology of young-onset hypertension and serve as a non-invasive and reliable screening tool when measured by MRI.

Clinical outcome in an infant with anti-NMDA receptor encephalitis: case report and literature review.

Anti N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disease that often presents with various neurological and neuropsychiatric symptoms. Although most reported cases occur in children, only a limited number of studies on children are available. The subject of this case report is an 8-month-old female who presented with fever, vomiting, and seizure. She was diagnosed with encephalitis and treated with acyclovir. After 21 days, she showed irritability, seizure, orolingual-facial dyskinesias, choreodystonic movements, hemiparesis, dysphagia, strabismus, lack of interest in light and objects. Clinical signs, neuroimaging findings, and serum analysis of anti-NMDAR antibodies confirmed the diagnosis of anti-NMDAR encephalitis. After the first line of treatment, she showed full recovery. We update the infants with anti-NMDAR encephalitis in the literature. Clinical outcomes suggest that patients with anti-NMDAR encephalitis are mostly poor in the infants, excluding our case. We propose that early and appropriate treatments are critical for timely diagnosis and rapid improvement.

Role of computed tomography findings, complete blood count parameters and systemic inflammatory markers for predicting the severity in interstitial lung diseases.

BACKGROUND AND OBJECTIVES: The present study aimed to find quantitative and semiquantitative methods to detect the development of fibroproliferative processes at an early stage and predict the severity and prognosis of the disease in interstitial lung diseases (ILDs) using High-Resolution Computed Tomography (HRCT), Pulmonary Function Tests (PFTs) and Complete Blood Count (CBC) parameters. MATERIALS AND METHODS: A total of 63 patients (26 female and 37 male) who were admitted to our hospital between January 2014 and January 2018, whose follow-ups were regular and who underwent HRCT, PFT, and CBC examinations on the same day, were included in our study. The median age of the patients included was 65 years (range: 47-79). RESULTS: There were significant differences among the mild, moderate, and severe form ILD groups created using the Warrick scoring system for NLR, neutrophil count, and PNR values (p = 0.025, 0.035, 0.006, respectively). Also, there were significant differences among the groups for FVC, FEV1/FVC, PAD, RAA, RV/LV ratio, MLnMD, and MLnC values. Correlation analyses between the parameters revealed significant relationships between Warrick Score, and NLR and neutrophil count, PNR, FVC, FEV1/FVC, PAD, RAA, RV/LV ratio, MLnMD, and MLnC . CONCLUSIONS: The results of the present study suggested that NLR, neutrophil count, and PNR values could be used as objective evaluation criteria to determine the severity and prognosis in interstitial lung diseases. Also, usage of Warrick Score, FVC, FEV1/FVC, PAD, RAA, RV/LV ratio, MLnMD, and MLnC values could provide quantitative and semiquantitative data for an objective evaluation. Carrying out multicenter studies and creating a scoring system using these parameters could create standardization in determining the prognosis of patients with ILD.

Incidence, follow-up and outcomes of incidental abdominal aortic aneurysms in computed tomography.

OBJECTIVES: The goal of our study was to determine the prevalence of abdominal aortic aneurysms (AAAs) that were incidentally diagnosed by computed tomography applied for different reasons and to discuss the risk factors that may cause AAA. METHODS: A total of 5396 abdominal computed tomography examinations were performed, and the 103 incidentally detected AAAs were included in the study. Patients with and without AAA were compared in terms of age, gender, thoracic and abdominal aortic diameters and comorbid diseases. RESULTS: The prevalence of the AAAs was 1.9%. Old age and male gender were significantly different between the groups (P < 0.001). The reason for applying computed tomography in 52 (50.5%) patients with AAA was associated with malignancy. In the evaluation of all patients in the study, the aortic diameter was determined to be larger in patients with malignancy than in patients without malignancy (18.07 ± 4.1 mm vs 17.7 ± 3.9 mm, respectively; P < 0.001). The thoracic aortic diameter was wider in patients with AAA compared to that in patients without AAA (37.2 ± 3.9 mm vs 33.9 ± 5.2 mm, respectively; P < 0.001). The presence of coronary artery disease, diabetes mellitus, hypertension and a history of smoking in patients with AAA was significantly different from that of patients without AAA (P < 0.001). There was no significant difference between the groups in terms of hyperlipidaemia and chronic obstructive pulmonary disease (P = 0.52 and P = 0.15, respectively). CONCLUSIONS: Screening of older men with diseases such as malignancy, hypertension, diabetes mellitus and coronary artery disease for AAA is important for the early diagnosis and treatment of this disease.

Evaluation of cardiovascular autonomic dysfunction according to heart rate turbulence and variability in patients with relapsing remitting multiple sclerosis

Background/aim: Multiple sclerosis (MS) is an autoimmune disease characterized by neurodegeneration or demyelination; the relapsing­remitting phase of MS is characterized by acute exacerbation of disease activity. The most commonly used noninvasive approach to assess autonomic function is the determination of heart rate turbulence (HRT) and heart rate variability (HRV). The aim of this study was to evaluate the presence of cardiovascular autonomic dysfunction using HRT and HRV parameters determined via 24-h Holter ECG monitoring in patients with relapsing­remitting MS without known heart disease. Materials and methods: The study included 26 patients diagnosed with relapsing­remitting MS and 22 age- and sex-matched healthy controls. HRT and HRV parameters were analyzed via 24-h Holter ECG monitoring. Magnetic resonance imaging findings were reevaluated to identify any demyelinating lesions in the brain stem. Results: The HRV parameters of SDNNI (mean of the standard deviations of all normal sinus RR intervals in all 5-min segments), rMSSD (root­mean­square successive difference), and sNN50 (percentage of successive normal sinus RR intervals >50 ms) were significantly lower in the MS group than in the control group (P < 0.05). Conclusion: This study revealed that the patients with MS had reduced HRV; this was demonstrated by dysfunction with regard to parasympathetic and sympathetic parameters in HRV analysis.

Evaluation of the CT imaging findings in the diagnosis of pulmonary hypertension due to chronic thromboembolism.

PURPOSE: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only pulmonary hypertension that can be treated surgically. Multidedector computerized tomography angiography (MDCTA) is considered as an important tool. In this study, the important CT findings of CTEPH and the vascular MDCTA findings of CTEPH were classified as central, peripheral, central and peripheral. The aim of this study was to investigate the relationship between these groups with parenchymal and hemodynamic findings. MATERIALS AND METHODS: MDCTA examinations of 26 patients who had been diagnosed with CTEPH were retrospectively reviewed. Vascular, cardiac and parenchymal findings were examined in MDCTA. Patients were divided into three groups as peripheral, central and peripheral and central chronic thromboembolism. The relationship between these groups with demographic, vascular, parenchymal and hemodynamic findings was investigated. RESULTS: The most common vascular finding was the wall filling defects attached to the lobar and/or segmental arterial walls, while the parenchymal finding was the fibrotic shrinkage. There were no statistically significant differences between the three groups compared to parenchymal findings which are mosaic pattern, brochiectasis, fibrotic changes and atelectasis, pulmonary artery diameter, right atrial diameter and RV/LV ratio. Age and sex were not different in patients between the three groups. CONCLUSION: The results of the this study confirm the important role of MDCTA in the evaluation of vascular, cardiac and parenchymal findings in the patients with CTEPH and identifying patients that would most benefit from surgical treatment by visualization of the segmental and subsegmental branches of the pulmonary arteries.

Relationship of mesenteric panniculitis with visceral and subcutaneous adipose tissue

Background/aim: Mesenteric panniculitis (MP) is an idiopathic benign disease characterized by fat necrosis, chronic inflammation, and fibrosis. The relationship between obesity and chronic low-grade inflammation has been reported. This study investigated the relationship of MP diagnosed using multidetector computed tomography (MDCT) with visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas. Materials and methods: We retrospectively enrolled 104 patients with no radiological findings other than MP. Additionally, 76 individuals without any indicative radiological findings were included as controls. VAT and SAT were separately calculated (cm2) using a 3-dimensional workstation. The abdominal circumference was measured (cm). Results: The mean abdominal circumference was 99.9 ± 7.9 cm, SAT was 195.3 ± 89.1 cm2, and VAT was 203.9 ± 72.8 cm2 in the MP group. The abdominal circumference, VAT, and SAT were significantly higher in the MP group than in the control group (P < 0.001). According to the receiver operating characteristic (ROC) analysis, cut-off level VAT and SAT were 167.5 cm2 (sensitivity 71%, specificity 69%) and 117.5 cm2 (sensitivity 78%, specificity 51 %), respectively. Conclusion: Increased VAT and SAT were associated with MP, suggesting their role in the etiology of MP.

Role of aortic stiffness and inflammation in the etiology of young-onset hypertension

Background/aim: Young-onset hypertension is a form of condition diagnosed in patients aged below 40. Cytokines such as interleukin (IL)-6 and also MCP-1 may play a role in the development of arterial hypertension. Aortic stiffness can be detected by measuring pulse wave velocity (PWV). We aimed to explore the relationship between inflammation and aortic stiffness and investigate their roles in the etiology of young-onset hypertension. Materials and methods: We enrolled 16 patients diagnosed with young-onset hypertension and 16 volunteers without hypertension. The plasma levels of MCP-1 and IL-6 were determined using an enzyme-linked immunosorbent assay and quantitative enzyme-linked immunoassay, respectively. Carotid-femoral PWV was measured using an arteriograph device. Results: Compared with those in normotensive controls, the plasma levels of IL-6 and MCP-1 and the PWV values were significantly higher in patients with young-onset hypertension (P < 0.001). PWV values were also positively correlated with the levels of MCP-1 and IL-6. However, no statistically significant difference was noted in intima-media thickness between the two groups (P = 0.224). Conclusion: In this study, increased PWVs and the levels of inflammation markers were associated with aortic stiffness and inflammation in patients with young-onset hypertension, suggesting they have a role in the etiology of hypertension.