Why is childhood urolithiasis increasing? Etiology, diagnosis and management: a single-center experience.

BACKGROUND: Globally, urolithiasis is becoming more and more common among children. We aimed to determine the etiology, and the diagnostic and therapeutic approaches in patients with urolithiasis. METHODS: This was a retrospective study which included all patients (aged 1 month-18 years) admitted to the pediatric nephrology clinic in Elazig Fethi Sekin City Hospital with urolithiasis between November 2019 and 2021. Only patients whose diagnosis of urolithiasis was confirmed by urinary ultrasonography were included in the study, while patients with chronic diseases (neurological diseases such as epilepsy, cerebral palsy, chronic bowel diseases, etc.) predisposing to kidney stone formation were not. Demographic characteristics, serum and urine biochemical parameters, urine metabolic and kidney stone metabolic and chemical analyses, urinary tract ultrasonography findings and treatment modalities were collected. RESULTS: One hundred ninety-seven patients (91 female and 106 male) were included in the study. Hypervitaminosis D was detected in 4 (2%) patients, suppressed parathyroid hormone in 12 (6%) and hypercalcemia in 27 (14%) patients. Metabolic screening showed hypercalciuria in 69 (35%) patients, hypocitraturia in 39 (20%), hyperoxaluria in 15 (8%) and cystinuria in 6 (3%) patients. Eighty three (42%) patients had a positive family history for kidney stones. One hundred eighteen (60%) patients received potassium citrate treatment, 71 (36%) were given hydration and diet recommendations without medical treatment, 6 (3%) received tiopronin treatment, and 2 (1%) patients were treated surgically. CONCLUSIONS: Our study suggests that Vitamin D supplementation at doses higher than 400 IU/day may be a risk factor for kidney stones in children. We observed that mothers tend not to give water to infants who are breastfed or formula-fed in the first year of life. K-citrate treatment can be a good option for prevention and dissolution of stones by alkalinization.

Can laboratory parameters be an alternative to CT and RT-PCR in the diagnosis of COVID-19? A machine learning approach.

In this study, a machine learning-based decision support system that uses routine laboratory parameters has been proposed in order to increase the diagnostic success in COVID-19. The main goal of the proposed method was to reduce the number of misdiagnoses in the RT-PCR and CT scans and to reduce the cost of testing. In this study, we retrospectively reviewed the files of patients who presented to the coronavirus outpatient. The demographic, thoracic CT, and laboratory data of the individuals without any symptoms of the disease, who had negative RT-PCR test and who had positive RT-PCR test were analyzed. CT images were classified using hybrid CNN methods to show the superiority of the decision support system using laboratory parameters. Detection of COVID-19 from CT images achieved an accuracy of 97.56% with the AlexNet-SVM hybrid method, while COVID-19 was classified with an accuracy of 97.86% with the proposed method using laboratory parameters.

Deep learning model for automated kidney stone detection using coronal CT images.

Kidney stones are a common complaint worldwide, causing many people to admit to emergency rooms with severe pain. Various imaging techniques are used for the diagnosis of kidney stone disease. Specialists are needed for the interpretation and full diagnosis of these images. Computer-aided diagnosis systems are the practical approaches that can be used as auxiliary tools to assist the clinicians in their diagnosis. In this study, an automated detection of kidney stone (having stone/not) using coronal computed tomography (CT) images is proposed with deep learning (DL) technique which has recently made significant progress in the field of artificial intelligence. A total of 1799 images were used by taking different cross-sectional CT images for each person. Our developed automated model showed an accuracy of 96.82% using CT images in detecting the kidney stones. We have observed that our model is able to detect accurately the kidney stones of even small size. Our developed DL model yielded superior results with a larger dataset of 433 subjects and is ready for clinical application. This study shows that recently popular DL methods can be employed to address other challenging problems in urology.

Untreated Isolated Torsion of the Epididymis in an Adolescent.

Although torsion of epididymis is extremely rare, it should be kept in mind in the differential diagnosis of acute scrotal pain in adolescents. We report here a very rare cause of acute scrotum: torsion of the epididymis.

[Primary Retroperitoneal Hydatid Cyst]. / Primer Retroperitoneal Kist Hidatik.

Hydatid disease is a parasitosis which is created by Echinococcus granulosus. Hydatid cysts most of ten settled in the liver and lungs. Hydatid cyst is rarely seen in retroperitoneal. Sixty-three year-old female patient was admitted to our hospital with complaints of abdominal distention and with back pain in the Abdominal ultrasonography and computed tomography images, on the posterior of the left kidney, in paravertebral area approximately 15 x 10 cm in size septal cystic lesion was observed retroperitoneally. At laparotomy, partial excision of the retroperitoneal cyst was performed and drainage of the cyst pouch was provided by suction drain. Suction drain was removed 5 days after surgery. Histopathological diagnosis is was reported as hydatid cyst. Hydatid disease is a endemic disease in our country and it should be known that has a typical placements.

Magnetic resonance imaging findings of musculoskeletal brucellosis.

OBJECTIVE: The aim of this retrospective study was to determine the magnetic resonance imaging (MRI) findings of patients with musculoskeletal brucellosis. MATERIALS AND METHODS: Sixty-eight among 304 patients with musculoskeletal brucellosis, aged 12-82 years (average, 50.2 years), were included in the study. Patients were diagnosed based on clinical findings, Brucella agglutination tests, and MRI findings. MRI was performed to all of the patients with sacroiliitis, spondylitis-spondylodiscitis, and peripheral arthritis. RESULTS: Brucella serum agglutination test was >1/160 in all cases and blood cultures were positive in twelve cases. The most commonly affected site was the spine (57.3%), wherein lumbar vertebrae were found to be most commonly affected. The second most common affected site was sacroiliac joint (26.4%), whereas peripheral joints were affected in 11 cases (16.1%). CONCLUSION: Brucellosis may affect various sites in musculoskeletal system. The spine was the most frequently affected site in our study. Sacroiliac joints and the other peripheral joints were less commonly involved sites. Brucellosis should be included in the differential diagnosis of a patient with arthralgia or symptoms of musculoskeletal system disorders especially in endemic areas.

Diffusion weighted MRI in chronic viral hepatitis: correlation between ADC values and histopathological scores.

OBJECTIVE: To investigate the utility of apparent diffusion coefficient (ADC) measurement in the diagnosis of chronic viral hepatitis (CVH) and correlation between ADC values and histopathologic severity of CVH. MATERIALS AND METHODS: The ADC values of liver parenchyma on diffusion-weighted magnetic resonance imaging (DWMRI) were measured in 50 patients with a history of CVH and 51 healthy subjects at b 100, b 600 and b 1,000 gradients. Comparison between mean ADC values of the CVH and control groups and correlation results between ADC values and necroinflammation and fibrosis scores in CVH were obtained. RESULTS: Mean ADC values of CVH patients were significantly lower than mean ADC values of the control group at b 100 and b 600 gradients (P < 0.05). There was no significant difference between the CVH and control groups at the b 1,000 gradient (P > 0.05). No significant correlation was found between ADC values and histopathologic scores of CVH (P > 0.05). CONCLUSION: ADC values obtained at the b 100 and b 600 gradients can be used to distinguish between the liver parenchyma of CVH and healthy subjects. ADC measurement was not found to be useful for estimation of the degree of necroinflammation and fibrosis in CVH. TEACHING POINTS: • In chronic viral hepatitis apparent coefficient values are decreased in the liver • There is no correlation between ADC values and histopathologic severity of CVH • DW images obtained at low b values have more ability to demonstrate an ADC decrease in viral hepatitis.