Comparison of the Efficacy of Systemic Versus Local Steroid Treatment in Idiopathic Granulomatous Mastitis: A Cohort Study.

INTRODUCTION: Steroid therapy is known to be effective against granulomatous mastitis. We aimed to compare the efficacy of local versus systemic steroid administration in patients with idiopathic granulomatous mastitis. MATERIALS AND METHODS: This prospective cohort study included 58 patients who had either local (n = 42) or systemic (n = 16) treatment due to granulomatous mastitis between 2015 and 2019. Recurrence rates were determined as per ultrasound and magnetic resonance imaging examinations and the rate of side effects was evaluated as per patient complaints and physical examinations at the end of a 2-year follow-up period. RESULTS: Median doses of 140 mg and 3810 mg were administered to the local and systemic group, respectively. Six (14.3%) patients in the local treatment group and 13 (81.3%) in the systemic treatment group had steroid-related side effects. The local treatment group had significantly fewer side effects than the systemic treatment group (P < 0.001). The recurrence rates were similar in both groups (P > 0.05). CONCLUSIONS: Local steroid injection was as effective as systemic steroid therapy. Compared to systemic therapy, local steroid administration can be considered as a new therapeutic protocol with a lower dose and side effect rate.

Anatomical-Based Imaging of Cystic Echinococcosis and Review of the Current Literature.

Echinococcosis is a zoonosis caused by cestodes of the genus Echinococcus. This serious disease continues to be an important public health problem as it is endemic in many parts of the world. Cystic disease affects many organs in the body, most commonly the liver. Hydatid disease can cause a diverse spectrum of symptoms, from asymptomatic infection to potential death. In the presence of clinical suspicion, the diagnosis is made by serology and imaging methods. Imaging findings can range from completely cystic lesions to completely solid appearance and calcification. The imaging method to be used depends on the involved organ and the stage of the cyst. The updated recommendations of the World Health Organization-Echinococcosis Informal Working Group for the stage and treatment of human echinococcosis have had important implications. Accordingly, there are 4 approaches to the clinical management of hydatid disease: surgery, percutaneous techniques and drug therapy for active cysts, and a "watch and wait" approach for inactive cysts. Since it directly affects the treatment, it is necessary to be familiar with the imaging findings of the cyst, especially in endemic areas.

The association of OSAS and uvula: the role of MRI in this egg-chicken problem in OSAS.

PURPOSE: Obstructive sleep apnea syndrome (OSAS) is a condition resulting from repetitive partial or complete upper airway obstruction, and its etiology remains uncertain. Polysomnography is the gold standard diagnostic test for OSAS. However, there are long wait times for this evaluation, so questionnaires or ancillary diagnostic methods are used to select appropriate patients. One of these is magnetic resonance imaging (MRI). The present study aimed to investigate the association between clinical features of OSAS and uvular changes on MRI. MATERIALS AND METHODS: A total of 102 participants, 80 with OSAS and 22 controls, were included in the study. All participants underwent full-night polysomnography, MRI, and anthropometric measurements. RESULTS: In comparisons of MRI measurements of the uvula, statistically significant differences in uvular length, thickness, and angle were observed between the OSAS and control groups. MRI measurement significantly associated with apnea-hypopnea index was uvular thickness. Evaluation of anthropometric and MRI measurements revealed statistically significant associations between waist circumference and uvular thickness, uvular width, and oropharyngeal space among the OSAS patients. CONCLUSION: Thickened uvula on MRI is associated with the presence of OSAS, and its thickness is well correlated with the severity of the diseases. Thus, it may be a reliable indicator of OSAS and could be used as a supportive finding to identify patients suitable for referral for diagnostic polysomnography.

Unusual Presentation of a Cerebral Dural Arteriovenous Fistula.

Dural arteriovenous fistula (DAVF) is a rare neurological condition. The imaging findings are enlarged vessels, thrombosed sinuses, and hemorrhage on adjacent brain parenchyma. Magnetic resonance imaging and computed tomography angiography can be used safely for diagnosis. In this paper, we report imaging findings of DAVF in an adult patient.