Is aortic knob width a novel predictor of mortality in hemodialysis patients?

OBJECTIVE: Identifying reliable predictors of mortality in end-stage renal disease patients is crucial for patient outcomes. Aortic knob width is a radiographic parameter used to assess cardiovascular diseases and atherosclerosis. This study investigated the association between aortic knob width and mortality in hemodialysis patients. PATIENTS AND METHODS: The study included data collected between 2007 and 2022 from 103 patients aged between 18 and 85 who had been undergoing hemodialysis treatment for at least one year. Patients were divided into two groups: survivors and deceased. The aortic knob width was measured using a posterior-anterior chest radiograph after midweek hemodialysis. The relationship between aortic knob width and mortality was investigated. RESULTS: Deceased patients had significantly larger aortic knob widths compared with survivors. The deceased group's hemodialysis (HD) duration was shorter, median age was older, Kt/V, hemoglobin, and albumin levels were lower, and the frequency of patients with hypertension, diabetes, and aortic wall calcification was higher. Aortic knob width greater than 37.98 mm was identified as a predictor of mortality in hemodialysis patients. Survival rates for aortic knob width <37.98 mm are 98.1% for 1 year and 64.9% for 15 years. For aortic knob width larger than 37.98 mm, survival rates are 88% for three years, 68% for five years, 45.2% for ten years, and 25% for fifteen years. The most important risk factors for increased aortic knob width were age, male sex, aortic calcification, and hypertension. CONCLUSIONS: Age, male gender, aortic calcification, and hypertension are the primary risk factors for increased aortic knob width in hemodialysis patients. Aortic knob width greater than 37.98 mm, which can be measured simply and rapidly using posterior-anterior chest radiography, may be a predictor of mortality. Graphical Abstract: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-10.jpg.

Epidemiological findings on Hepatitis C infection in a tertiary level hospital in mid-northern Anatolia in Turkey: A four-year analysis

@# The hepatitis C virus (HCV) is a blood-borne pathogen that causes acute or chronic infection of the liver, sometimes leading to serious liver damage and fatality. The objective of this study was to evaluate HCV prevalence in patients attending the Regional Training and Research Hospital for Medical Examination and Surgery in Samsun Province of Turkey between 2014 and 2017. Blood specimens taken from 152 596 patients were screened for HCV infection by using the anti-HCV assay. Seropositive samples were subjected to polymerase chain reaction (PCR) testing in order to determine whether the HCV infection was active. Genotyping was then performed. Overall, HCV seropositivity and active HCV infection were 2.76% and 2.05%, respectively. Foreign nationals accounted for 5.61% of the seropositive samples and 1.37% of active HCV infective samples. We further report that 2017 was the year with the highest seroprevalence which was 3.64%. HCV genotype 1 was the most common genotype detected in residents of Samsun Province at 89.86%, followed by Genotype 3 at 4.54%. This study provides important information on the levels of HCV infection in the Samsun region of Turkey. The data indicate that there was a rising trend of HCV infection between 2014 and 2017.

The effect of dietary supplements on healing of alloplastic bone grafted defects in rat tibia / Efecto de los suplementos dietarios sobre la cicatrización de defectos injertados con hueso aloplástico en la tibia de ratas

The aim of this investigation was to evaluate the potential effects of the systemically delivered combination of calcium, zinc and vit-d supplementation of the locally applied alloplastic bone graft. 28 male Wistar albino rats were used in this study. In each animal, bone defects (10 mm length ¥ 3 mm width ¥ 2 mm depth) were created in the tibias. The animals were divided into four groups. In Group 1 (Control Group) rats were fed with standard rat diet. In Group 2 (Calcium Group) rats received calcium carbonate (15 mg/kg body weight) suspended in saline. In Group 3 (Calcium/Zinc Group) rats received calcium carbonate (15 mg/kg body weight) and zinc sulfate (4 mg/kg body weight) suspended in saline. In Group 4 (Calcium/Vitamin D Group) rats received calcium carbonate (15 mg/kg body weight) and Vitamin D (500 IU/kg body weight) suspended in olive oil. Histopathological analysis of samples was performed to evaluate the process of osteoblastic activity, matrix formation, trabecular bone formation and myeloid tissue in bone defects. Total amounts of osteoblastic activity, matrix formation, trabecular bone formation and myeloid yissue in Ca Group (p= 0.002), Ca/Zinc Group (p= 0.002), and Ca/Vit.D Group (p= 0.001) were significantly higher than in Control Group. The total amounts of Ca/Vit.D Group were significantly different than Control Group and Ca Group. The results of the present study indicated that the oral calcium carbonate supplementation combination with zinc may have systemic effects on accelerating bone regeneration in alloplastic bone grafted tibial defects. Further human studies involving long-term follow up and different type of bone grafts should be conducted.

El objetivo de esta investigación fue evaluar los efectos potenciales de la combinación sistémica de calcio, zinc y vitamina D como suplemento de la aplicación local de un injerto óseo aloplástico. Fueron utilizadas 28 ratas Wistar albinas (machos). En cada animal, se crearon defectos óseos en las tibias (cuyas medidas fueron: 10 mm de longitud x 3 mm de ancho x 2 mm de profundidad). Los animales fueron divididos en cuatro grupos. En el Grupo 1 (control) las ratas fueron alimentadas con una dieta estándar. En el Grupo 2 (grupo de calcio) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) suspendido en solución salina. En el Grupo 3 (grupo de calcio/zinc) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) y sulfato de zinc (4 mg/kg de peso corporal) suspendido en solución salina. El Grupo 4 (calcio/vitamina D) recibió carbonato de calcio (15 mg/kg de peso corporal) y vitamina D (500 UI/kg de peso corporal) suspendidos en aceite de oliva. Se realizó un análisis histopatológico de las muestras para evaluar el proceso de actividad osteoblástica, formación de la matriz, hueso trabecular y tejido mieloide en defectos óseos. Las cantidades totales de actividad osteoblástica, formación de matriz, de hueso trabecular y tejido mieloide en los grupos Calcio (p= 0,002), Calcio/Zinc (p= 0,002), y Calcio/Vitamina D (p= 0,001) fueron significativamente mayores que en el grupo de control. Las cantidades totales de Calcio/Vitamina D Grupo fueron significativamente diferentes de los grupos Control y Calcio. Los resultados del presente estudio indican que lacombinación de suplementos de carbonato de calcio por vía oral con zinc puede tener efectos sistémicos sobre la aceleración de la regeneración ósea en defectos tibiales con injertos aloplásticos. Deben llevarse a cabo otros estudios en humanos, que involucren un largo plazo de seguimiento y también diferentes tipos de injertos óseos.

Evaluación mediante PET/TAC con 18FDG de la actividad metabólica hepática en pacientes con hígado graso de origen no alcohólico / Evaluation of hepatic metabolic activity in non-alcoholic fatty livers on 18FDG PET/CT

Objetivo. El hígado se ha usado como órgano de referencia para evaluar la captación anormal de la 18F-fluoro-2-deoxi- d -glucosa (18FDG). Algunos trabajos publicados muestran que la esteatosis hepática modifica la captación hepática de 18FDG, mientras que otros no encuentran modificaciones. Este trabajo ha estudiado si la captación hepática de 18FDG se ve afectada por la infiltración grasa difusa del hígado. Material y métodos. En este estudio se incluyeron 156 casos. Se definieron diferentes grupos de pacientes de acuerdo a las unidades Hounsfield (HU) del hígado. En todos los pacientes, las HU se calcularon a partir de la TAC sin contraste. Además se calculó el SUVmedio y el SUVmáx en el estudio PET con 18FDG. Para ello se dibujaron regiones de interés (ROI) sobre el área hepática. Se realizó una comparación estadística del SUVmedio y SUVmáx medidos en los pacientes con hígado graso y en un grupo control. Resultados. En el grupo de pacientes, los promedios de SUVmedio y SUVmáx fueron 2,58±0,66 y 3,94±1, respectivamente; en el grupo control fueron 2,54±0,57 y 3,7±0,88, respectivamente. Encontramos que los promedios del SUVmedio y SUVmáx en los pacientes con hígado graso no fueron significativamente diferentes a los valores del grupo control (p>0,05). Asimismo, no detectamos correlación estadísticamente significativa entre los valores de la densidad media del hígado, medida en HU, y el promedio de los SUV (p>0,05). Conclusión. La infiltración grasa no parece tener un efecto significativo sobre la captación hepática de 18FDG. Por ello, el hígado se puede usar como órgano de referencia en los estudios PET con 18FDG realizados en pacientes con enfermedad grasa hepática(AU)

Objective. The liver has been used as a reference organ for the assessment of abnormal 18F-fluoro-2-deoxy- d -glucose (18FDG) in the body. Some researchers found that hepatosteatosis significantly changed the hepatic 18FDG uptake, while others did not. This study investigated whether the liver's 18FDG uptake was affected by the diffuse fatty infiltration of the liver. Material and methods. A total of 156 cases were included in this study. Different patient groups were defined according to the liver Hounsfield unit (HU). The HU was calculated from an unenhanced CT, for all patients, and we calculated the mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax) on an 18FDG PET scan. For this purpose, we placed regions of interest (ROIs) on the liver image. We statistically compared the SUVmean and SUVmax measured in the fatty liver patients and the control group. Results. The average SUVmean and SUVmax values were calculated as 2.58±0.66 and 3.94±1, respectively, in the patient group and 2.54±0.57 and 3.7±0.88, respectively, in the control group. We found the average SUVmean and SUVmax values in the fatty liver group and its subsets were not significantly different from the values in the control group (p>0.05). We also did not find any statistically significant correlation between average liver density (HU) and the average SUV values (p>0.05). Conclusion. Fatty infiltration may not have a significant effect on the liver's 18FDG uptake. Thus, the liver may be used as a reference or comparator on 18FDG PET scans in patients with fatty liver disease(AU)

Chronic myeloid leukemia detected on FDG PET/CT imaging in a patient with renal cell carcinoma / Leucemia mieloide crónica detectada con FDG PET/TAC en un paciente con carcinoma de células renales

Es por todos conocido que la estimulación citocina hematopoyética puede causar un aumento en la acumulación de fluorodeoxiglucosa (FDG) en la medula ósea en las imágenes del PET/TAC de pacientes con metástasis en la medula ósea. Sin embargo, la captación aumentada por la medula ósea puede deberse a otras etiologías. Presentamos el caso de un paciente operado de carcinoma de células renales sin una historia de estimulación hematopoyética. Las imágenes de la FDG PET/TAC muestran la captación aumentada de FDG en la medula ósea y el paciente fue diagnosticado de leucemia mieloide crónica. Este caso muestra que la captación aumentada de FDG en la medula ósea puede relacionarse con la enfermedad neoplástica de los tejidos hematopoyéticos(AU)

It is well known that hematopoietic cytokine stimulation can cause increased fluorodeoxyglucose (FDG) accumulation in bone marrow on PET/CT imaging, which simulates that seen in patients with bone marrow metastases. However, increased bone marrow FDG uptake can be caused by other etiologies. We report a patient with operated renal cell carcinoma had no history of hematopoietic cytokine stimulation. The FDG PET/CT images showed increased bone marrow FDG uptake, and the patient was diagnosed as chronic myeloid leukemia. This case revealed that increased FDG uptake on bone marrow may be related to neoplastic disease of the hematopoietic tissues(AU)

The value of FDG-PET/CT in the post-treatment evaluation of endometrial carcinoma: A comparison of PET/CT findings with conventional imaging and CA 125 as a tumour marker

Objetivos. Este estudio retrospectivo fue diseñado para evaluar el valor de la tomografía por emisión de positrones/tomografía axial computerizada (PET/TAC) en la evaluación pos-tratamiento de pacientes con cáncer de endometrio y comparar el estudio de PET/TAC con imágenes convencionales (IC), incluyendo la tomografía axial computerizada (TAC), ecografía (echo) y resonancia magnética (RM) y CA 125 con valores de corte de 20U/Ml y 35ml. Materiales y métodos. Se realizó un estudio de PET/TAC en 31 pacientes tratados por adenocáncer endometrio comprobado histopatologicamente para obtener reestadiaje y en la presencia de sospecha de recaída. Se realizaron 35 estudios de PET/TAC en 31 pacientes. El estado de la lesión fue determinado a partir del seguimiento clínico, incluyendo imágenes radiológicas (seguimiento del estudio de TAC) después de al menos 6 meses y respuesta a tratamiento. Resultados. Trece (37%) de los 35 estudios PET/TAC fueron positivos y 22 (63%) negativos. El análisis basado en el estudio demostró sensibilidad, especificidad, precisión para las imágenes de PET/TAC de 100%, 96% y 97%, respectivamente. Los datos correspondientes para la IC fueron 46%, 87% y 74% y para CA 125 (punto de corte=20U/ml), las mediciones fueron 27%, 100% y 78%, respectivamente. Basado en el análisis de la lesión, la PET/TAC sólo demostró un caso de falso positivo. No fueron observadas recaídas clínicas o radiológicas con un seguimiento de al menos 6 meses en los 21 pacientes con 22 estudios negativos de PET/TAC. Conclusiones. La FDG-PET/TAC es una modalidad más útil que la IC y CA 125 en la evaluación post-tratamiento de pacientes con cáncer de endometrio en búsqueda de sospecha de recaída(AU)

Objectives. This retrospective study was designed to assess the value of positron emission tomography/computed tomography imaging (PET/CT) in the post-treatment evaluation of the patients with endometrial carcinoma and to compare PET/CT scan with conventional imaging (CI) including computed tomography (CT), ultrasonography (US) and magnetic resonance imaging (MRI) and CA 125 with both 20U/ml and 35U/ml cut-off values. Materials and methods. A total of 31 patients who were treated for histopathologically proven endometrial adenocarcinoma, underwent PET/CT examination for restaging and suspected recurrence. Thirty five PET/CT studies were performed in 31 patients. Lesion status was determined on the basis of clinical follow-up including radiological imaging (follow-up CT scan) at least 6 months and response to therapy. Results. Of the 35 PET/CT studies, 13 (37%) studies were positive, whereas 22 (63%) of them were negative. On study-based analysis the overall sensitivity, specificity, accuracy for PET/CT imaging were 100%, 96% and 97%, respectively. The corresponding information for CI were 46%, 87% and 74%, for CA 125 (cut off=20U/ml) measurement were 45%, 88% and 74%, and for CA 125 (cut off=35U/ml) measurement were 27%, 100% and 78%, respectively. On lesion-based analysis, PET/CT revealed only one false positive case. In none of 21 patients with negative 22 PET/CT studies, no subsequent clinical or radiological recurrences were observed with a follow-up of at least 6 months. Conclusion. FDG-PET/CT is found more useful modality than CI and CA 125 in the evaluation of post-treatment endometrial carcinoma patients, for suspected recurrence(AU)

Renograma con mercaptoacetiltriglicina para el diagnóstico diferencial de necrosis tubular aguda y nefritis intersticial asociada a vancomicina / Mercaptoacetyltriglycine renal scan for the differential diagnosis of acute tubular necrosis and interstitial nephritis associated to vancomycin

El diagnóstico diferencial de toxicidad renal asociada a la vancomicina incluye la necrosis tubular aguda y la nefritis intersticial. Se presenta un caso de toxicidad renal inducida por vancomicina, demostrada en el renograma con 99mTc-MAG3. La nefrotoxicidad se desarrolló secundariamente a vancomicina utilizada en el tratamiento de un paciente con meningitis. El renograma con 99mTc-MAG3 puede desempeñar un papel en el diagnóstico diferencial entre necrosis tubular aguda y nefritis tubulointersticial en caso de toxicidad renal asociada a vancomicina y puede facilitar la toma de decisiones clínicas(AU)

The differential diagnosis of vancomycin associated renal toxicity includes acute tubular necrosis and interstitial nephritis. We report a case of vancomycin induced renal toxicity shown by Tc-99m mercaptoacetyltriglycine renal scan. Nephrotoxicity was evolved secondary to vancomycin used for treating a patient with meningitis. Tc-99m mercaptoacetyltriglycine renal scan may play a role in differentiation between acute tubular necrosis and tubulointerstitial nephritis of vancomycin associated renal toxicity and can facilitate the clinical decision making(AU)

El papel de FDG-PET/TAC en pacientes con cáncer de ovario con marcadores tumorales altos o lesión con sospecha con TAC con contraste en la evaluación de recurrencia y/o en la determinación de metástasis intraabdominales / The Role of FDG-PET/CT in Ovarian Cancer Patients with High Tumor Markers or Suspicious Lesion on Contrast-Enhanced CT in Evaluation of Recurrence and/or in Determination of Intraabdominal Metastases

Objetivos. Este estudio retrospectivo fue diseñado para investigar el papel de una tomografía por emisión de positrones con 18F-fluorodeoxiglucosa/tomografía axial computerizada (PET-FDG) (FDG- PET/CT) en la determinación de recurrencia y/o metástasis intraabdominal en pacientes con cáncer de ovario con marcadores tumorales aumentados o lesión de sospecha detectada con TAC abdominal con contraste (TAC-c). Materiales y métodos. Se realizó un estudio PET/TAC en 34 pacientes femeninos tratados por cáncer de ovario verificado histopatológicamente para reestratificación y sospecha de recurrencia. Se incluyeron a pacientes con informe patológico, niveles de marcador tumoral, TAC-c y PET/TAC dentro de un mes del estudio. Resultados. Se reclutaron a 34 pacientes, 25 de las cuales tenían un nivel alto del marcador tumoral CA 125. Las 9 pacientes restantes tenían sospecha de recurrencia en la imagen del TAC-c con niveles del marcador tumoral normales. Se confirmaron recurrencia con re-operación y biopsia (n=4), seguimiento clínico y de imagen (n=21) en 25 pacientes y marcadores tumorales elevados. No se encontraron enfermedad recurrente en 5 de 25 pacientes en la imagen TAC-c y 1 de 25 pacientes en la imagen PET/TAC con altos niveles de CA125. Tanto TAC-c y el PET/TAC demostraron enfermedad recurrente en 19 de 25 pacientes. La sensibilidad, especificidad y presión del PET/TAC fueron 96,1, 100 y 97%, respectivamente. Conclusión. PET/TAC es un método beneficioso para la detección de recurrencia en pacientes con un nivel de CA 125 en suero elevado y hallazgos negativos en la TAC, o con un nivel normal de CA 125 y recurrencia detectado por TAC llevado a cabo debido a síntomas clínicos(AU)

Objectives. This retrospective study was designed to investigate the role of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in determination of recurrence and/or intraabdominal metastasis in patients with ovarian cancer having increased tumor markers or suspicious lesion detected by a contrast-enhanced abdominal CT (ceCT). Materials and methods. A total of 34 female patients who were treated for histopathologically proven ovarian cancer, underwent PET/CT examination for restaging and suspected recurrence. Patients with pathology report, tumor marker levels, ceCT and PET/CT performed within one month were included in the study. Results. A total of 34 patients were included in the study. 25 of 34 patients had high tumor marker (CA 125) level. The remaining 9 patients had suspected recurrence on ceCT imaging with normal tumor marker levels. Recurrence was confirmed by re-operation and biopsy (n=4), clinical and imaging follow-up (n=21) in 25 patients with elevated tumor markers. Recurrent disease was not shown in 5 of 25 patients on ceCT imaging and 1 of 25 patients on PET/CT imaging with high CA125 values. Both ceCT and PET/CT revealed recurrent disease in 19 of 25 patients. PET/CT showed more lesions in 11 of 19 patients. Sensitivity, specificity and accuracy of the PET/CT were 96.1%, 100% and 97%, respectively. Conclusion. PET/CT is found as a beneficial method for detection of the recurrence, in patients with increased serum CA 125 level and negative CT findings or with normal CA 125 level and recurrence detected by CT which was performed due to clinical symptoms(AU)

Ganglios linfáticos y epitrocleares visualizadas en FDG-PET/CT en una paciente con artritis reumatoide / Epitrochlear and axillary lymph node visualization on FDG-PET/CT imaging in a patient with rheumatoid arthritis

Una paciente de 38 años con cáncer de lengua fue referida para un estudio de FDG-PET/CT para evaluar los ganglios linfáticos y re- estadificación de malignidad. La captación bilateral de los ganglios epitrocleares y axilares fueron observados en la imagen del PET/CT. Fue inesperado el patrón de captación para esta paciente con esta malignidad y la historia de artritis reumatoide que tenía. Además, se incluyeron las muñecas en el campo de visión, las cuales manifestaron una elevada captación de FDG. En este caso clínico, informamos de la captación del trazador de epitroclear y axilar benigno en el estudio del FDG-PET/CT en una paciente con historia de artritis reumatoide(AU)

An 38 year-old female with oral tongue cancer was referred for FDG-PET/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the field of view and showed elevated FDG uptake. In this case report, we report benign axillary and epitrochlear tracer uptake on FDG-PET/CT scan in a patient with a history of rheumatoid arthritis(AU)