Imaging findings of traumatic injuries in survivors of the 6 February 2023 earthquake in Turkey.

In the southeastern part of Turkey, two earthquakes measuring 7.7 and 7.8 on the Richter scale occurred within 9 h on 6 February 2023, causing 120,000 injuries and over 50,000 deaths. Evacuees were transferred to various secondary and tertiary hospitals as the health system and hospitals in the affected region were affected by the earthquake. Injuries were mostly caused by blunt trauma and/or prolonged bruising under rubble. The severity and pattern of traumatic injuries in earthquake victims differed from other trauma patients who were not affected by an earthquake. In addition to traumatic injuries that affected multiple body regions and systems, patients who were trapped under debris for long periods of time were also frequently found to have crush syndrome. Pulmonary thromboembolism and hypoxic-ischaemic brain injury were observed in some patients. In this review, we present the imaging findings of traumatic injuries in earthquake victims, emphasising the earthquake-related distinct injury types.

Role of machine learning algorithms in predicting the treatment outcome of uterine fibroids using high-intensity focused ultrasound ablation with an immediate nonperfused volume ratio of at least 90.

OBJECTIVE: This study aimed to investigate the role of machine learning (ML) classifiers to determine the most informative multiparametric (mp) magnetic resonance imaging (MRI) features in predicting the treatment outcome of high-intensity focused ultrasound (HIFU) ablation with an immediate nonperfused volume (NPV) ratio of at least 90%. PATIENTS AND METHODS: Seventy-three women who underwent HIFU treatment were divided into groups A (n=47) and B (n=26), comprising patients with an NPV ratio of at least 90% and <90%, respectively. An ensemble feature ranking model was introduced based on the score values assigned to the features by five different ML classifiers to determine the most informative mpMRI features. The relationship between the mpMRI features and the immediate NPV ratio of 90% was evaluated using Pearson's correlation coefficients. The diagnostic ability of the ML classifiers was evaluated using standard performance metrics, including the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity in eight folds cross-validation. RESULTS: For all the 12 most informative features, the area under receiver operating characteristic curve (AUROC), accuracy, specificity, and sensitivity ranged from 0.5 to 0.97, 0.34 to 0.97, 0.56 to 1.0, and 0.87 to 1.0, respectively. The gradient boosting (GBM) classifier demonstrated the best predictive performance with an AUROC of 0.95 and accuracy of 0.92, followed by the random forest, AdaBoost, logistic regression, and support vector classifiers, which yielded an AUROC of 0.92, 0.92, 0.83, and 0.78 and accuracy of 0.96, 0.88, 0.84, and 0.84, respectively. GBM had the best classifier performance with the best performing features from each mpMRI group, Ktrans ratio of the fibroid to the myometrium, the ratio of area under the curve of the fibroid to the myometrium, subcutaneous fat thickness, the ratio of apparent diffusion coefficient value of fibroid to the myometrium, and T2-signal intensity of the fibroid. CONCLUSIONS: The preliminary findings of this study suggest that the most informative and best performing features from each mpMRI group should be considered for predicting the treatment outcome of HIFU ablation to achieve an immediate NPV ratio of 90%.

Morphological overview of cardiovascular comorbidities in chronic obstructive pulmonary disease: Frank's sign.

OBJECTIVE: Cardiovascular diseases are the most common and important comorbidities in patients with chronic obstructive pulmonary disease (COPD). Literature indicates that there may be a relationship between diagonal earlobe crease (DELC) and coronary artery disease (CAD). Accordingly, the present study aimed to assess the relationship with DELC and cardiac comorbidities in patients with COPD during routine physical examination. MATERIALS AND METHODS: In this prospective cohort study, we evaluated the demographic data, pulmonary function test (PFT) results, lipid profile, oxygen saturation, and the presence of DELC in patients with COPD and control subjects. RESULTS: DELC was diagnosed in 155 (62%) of COPD patients and these patients had a higher prevalence of CAD (p = 0.044). Moreover, DELC was diagnosed in 135 men (68.5%) and 20 (37.7%) women in the COPD group (p<0.001) and in 39 (48.8%) men and 14 (56.0%) women in the control group (p = 0.527). On the other hand, CAD was diagnosed in 18% of patients with early-stage COPD (n = 104) and in 30.8% of patients with late-stage COPD (n = 146) (p = 0.041). The sensitivity and specificity of DELC positivity in predicting CAD were 80.65% and 44.15% in COPD patients, respectively. CONCLUSION: The presence of cardiac comorbidities in COPD patients may play a vital role in the severity of the disease, exacerbations, and may also reduce the treatment response. Accordingly, an earlobe examination of patients with COPD may be useful in predicting the presence of cardiac comorbidities with high sensitivity.

Short-term variations of optic coherence tomography findings in mild and severe chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate the short-term changes in subfoveal choroidal thickness (SFCT), ganglion cell complex (GCC) analysis, and retinal nerve fiber length (RNFL) of patients with chronic obstructive pulmonary disease (COPD) in a 3-month follow-up. MATERIALS AND METHODS: Forty-eight patients with COPD (96 eyes) and 40 control subjects (80 eyes) were enrolled in our study. COPD patients were grouped according to disease severity as Group 1 (mild-moderate) and Group 2 (advanced). GCC, RNFL, and SFCT analysis by Cirrus SD-OCT were obtained for all eyes, in two consecutive examinations with a 3-month interval. RESULTS: SFCT in Group 2 was lower than Group 1 and control group in the initial and 3rd month examination (p < 0.001, respectively). Inferior RNFL in Group 2 were lower than control group in the initial and 3rd month examination (p = 0.002, p < 0.001, respectively) Temporal RNFL were lower in Group 2 than Group 1 in 3rd month examination (p = 0.009). Average, superior, superotemporal, inferior, and inferonasal GCC analyses of the Group 2 were lower than control group both in the initial and 3rd month examination (p = 0.001, p < 0.001, respectively) SFCT, average, and superior GCC of Group 2 were significantly reduced during the 3-month follow-up (p < 0.001). CONCLUSION: Hypoxia is thought to be the underlying mechanism in COPD, which may influence retinal and choroidal OCT parameters. Decrease in blood flow of optic nerve head, increased vascular resistance, and reduced blood flow in choroid may affect the visual ability in these patients, which should be kept in mind during their follow-up.

Neuroprotective effects of high-dose human albumin against traumatic spinal cord injury in rats.

BACKGROUND AND OBJECTIVES: Human serum albumin (HA) is a unique multifunctional protein with neuroprotective properties. We aimed to delineate the mechanisms of HA-induced neuroprotection, supresses inflammatory response and lipid peroxidation after spinal cord injury (SCI). METHODS AND STUDY DESIGN: Adult female Wistar rats weighing 210-250 g were used for the study. The rats were randomly and blindly allocated into five groups. The one-way analysis of variance (ANOVA) for parametric data and Shapiro-Wilk test was used for evaluating the normal distribution of the variables. Kruskal-Wallis for nonparametric data was used to compare groups. Electron and light microscopies were used to demonstrate ultrastructural changes in spinal cord. RESULTS: The HA group was significantly different from all the other groups (p < 0.05). Both MPSS and HA treatments decreased the MPO significantly. HA treatment decreased the lipid peroxidation. HA treatment prevented the worsening of clinical results. In the HA treatment group, the ultrastructure was protected significantly. The neuronal bodies and axonal structures were normal except for some limited edematous spaces. CONCLUSIONS: HA improves early clinical results, protects spinal cord ultrastructure, and decreases MPO and LPO levels after spinal cord contusion injury (Tab. 3, Fig. 3, Ref. 39).

THE EFFECTS OF VARIOUS DOSES OF PREDNISOLONE ADMINISTRATION ON SERUM VASPIN LEVELS IN RATS.

AIM: The aim of this study was to investigate the dose-dependent effects of prednisolone administration on serum vaspin levels and correlate this with changes in the BMI and lipogenesis in rats. MATERIALS AND METHODS: Twenty-four albino Wistar male rats weighing between 190-240 g were divided into four groups, three experimental (5 mg/kg, 10 mg/kg, and 20 mg/kg prednisolone) and one control. The prednisolone groups were given once-daily doses for 30 days, orally. In addition, the rats were weighed, and their height and waist circumferences were measured once a week. At the end of 30 days, vaspin and glucose levels were measured from blood samples. RESULTS: In the prednisolone groups, the vaspin levels significantly increased when compared with the control group. The control group has a serum vaspin level of 155 ± 20.99 pg/mL and this level has been increased by prednisolone administration in a dose dependent manner. In the prednisolone groups, especially the 10 mg/kg and 20 mg/kg groups, the glucose levels increased in a dose dependent fashion. CONCLUSION: Prednisolone administration significantly increased serum glucose and vaspin levels in a dose dependent manner, indicating that the increase in the serum vaspin levels could be related to the increase in the serum glucose concentration. Vaspin can be a molecule that is released in response to increased glucose and can be a rebound defense mechanism to modulate the blood glucose concentration. We suggest vaspin as a potential target for the treatment and diagnosis of diabetes mellitus and other metabolic disorders.

Is there any correlation between levels of serum ostepontin, CEA, and FDG uptake in lung cancer patients with bone metastasis? / ¿Existe correlación entre los niveles de osteopontina en suero sanguíneo, CEA y captación de 18F-FDG en pacientes con metástasis óseas por cáncer de pulmón?

Objective. In this study, an evaluation was made of the relationship between the serum levels of carcinoembryonic antigen (CEA), osteopontin (OPN), and the semi-quantitative parameters of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in lung cancer patients with bone metastasis. Material and methods. The evaluation included 42 non-small cell lung cancer (NSCLC) and 31 small cell lung cancer (SCLC) patients who were referred to our institution for staging by 18F-FDG PET/CT. The biochemical parameters measured included CEA and OPN serum levels. Results. Serum levels of OPN in NSCLC patients with and without bone metastasis were 21.20 ± 4.97 ng/ml and 13.33 ± 4.53 ng/ml, respectively (p < 0.05). In SCLC patients with and without bone metastasis serum OPN levels were 23.95 ± 4.78 ng/ml and 17.30 ± 3.09 ng/ml, respectively (p < 0.05). Serum levels of CEA in NSCLC patients with and without bone metastasis were 33.79 ± 6.49 ng/ml and 11.74 ± 2.96 ng/ml, respectively (p < 0.05). In SCLC patients with and without bone metastasis serum levels of CEA were 28.93 ± 4.59 ng/ml and 13.88 ± 4.47 ng/ml, respectively (p < 0.05). There were no correlations between primary tumor SUVmax, and serum levels of CEA and OPN. Conclusions. Bone metastasis can be detected in patients with lung cancer by measuring CEA and OPN levels. Increased levels of CEA and OPN levels may be considered an early warning sign in patients needing accurate imaging, as they are at higher risk of bone metastasis (AU)

Objetivo. Evaluar la relación entre los niveles de antígeno carcinoembriionario (CEA), osteopontina (OPN) y los valores semicuantitativos (SUV) de la PET/TC con 18F-FDG en pacientes con metástasis óseas por cáncer de pulmón. Material y método. Se incluyeron 40 pacientes con cáncer de pulmón de células no pequeñas (NSCLC) y 31 pacientes con cáncer de pulmón de células pequeñas (SCLC) referidos a nuestro centro para la realización de un estudio PET/TC con 18F-FDG de estadificación. Se analizarón los niveles sanguíneos de OPN y CEA. Resultados. Los niveles de OPN en pacientes con NSCLC con y sin metástasis óseas fueron de 21.20 ± 4.97 ng/ml y 13.33 ± 4.53 ng/ml, respectivamente (p < 0.05). En pacientes con SCLC con y sin metástasis óseas fueron de 23.95 ± 4.78 ng/ml y 17.30 ± 3.09 ng/ml, respectivamente (p < 0.05). Los niveles sanguíneos de CEA en pacientes de NSCLC con y sin metástasis óseas fueron de 33.79 ± 6.49 ng/ml y 11.74 ± 2.96 ng/ml, respectivamente (p < 0.05). En pacientes con SCLC con y sin metástasis óseas fueron de 28.93 ± 4.59 ng/ml y 13.88 ± 4.47 ng/ml, respectivamente (p < 0.05). No hubo correlación entre el SUV máximo del tumor primario, los niveles OPN ni de CEA. Conclusiones. La metástasis ósea puede ser detectada en pacientes con cáncer de pulmón con la determinación de los niveles de OPN y CEA. Los niveles incrementados de CEA y OPN pueden ser considerados como una señal de advertencia temprana en pacientes que necesiten imágenes precisas, porque ellos están en mayor riesgo de metástasis en el hueso (AU)

Results of one-stage surgical treatment in children with Tönnis grade 4 developmental dysplasia of the hip: is it worse when it is bilateral?

This retrospective study compared the results of one-stage surgery of unilateral and bilateral Tönnis grade 4 hips (high dislocation in developmental hip dysplasia, DDH) : 41 hips, 30 patients. Mean follow-up was 56 months. Pelvic radiographs were evaluated at three time points. Acetabular inclination angle improved significantly in both groups. Results were satisfactory (Severin classes I-II) in 13 hips (68.5%) (unilateral group) and 21 hips (89.5%) (bilateral group). Functional evaluation (McKay classification) at final follow-up revealed satisfactory results in 94.8% (unilateral group) and 63.6% (bilateral group). One-stage surgery is a reliable method for treating children with unilateral or bilateral DDH.

Is there any correlation between levels of serum ostepontin, CEA, and FDG uptake in lung cancer patients with bone metastasis?

OBJECTIVE: In this study, an evaluation was made of the relationship between the serum levels of carcinoembryonic antigen (CEA), osteopontin (OPN), and the semi-quantitative parameters of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in lung cancer patients with bone metastasis. MATERIAL AND METHODS: The evaluation included 42 non-small cell lung cancer (NSCLC) and 31 small cell lung cancer (SCLC) patients who were referred to our institution for staging by (18)F-FDG PET/CT. The biochemical parameters measured included CEA and OPN serum levels. RESULTS: Serum levels of OPN in NSCLC patients with and without bone metastasis were 21.20±4.97 ng/ml and 13.33±4.53 ng/ml, respectively (p<0.05). In SCLC patients with and without bone metastasis serum OPN levels were 23.95±4.78 ng/ml and 17.30±3.09 ng/ml, respectively (p<0.05). Serum levels of CEA in NSCLC patients with and without bone metastasis were 33.79±6.49 ng/ml and 11.74±2.96 ng/ml, respectively (p<0.05). In SCLC patients with and without bone metastasis serum levels of CEA were 28.93±4.59 ng/ml and 13.88±4.47 ng/ml, respectively (p<0.05). There were no correlations between primary tumor SUVmax, and serum levels of CEA and OPN. CONCLUSIONS: Bone metastasis can be detected in patients with lung cancer by measuring CEA and OPN levels. Increased levels of CEA and OPN levels may be considered an early warning sign in patients needing accurate imaging, as they are at higher risk of bone metastasis.

The lung endothelin system: a potent therapeutic target with bosentan for the amelioration of lung alterations in a rat model of diabetes mellitus.

PURPOSE: The aim of this study is to show the effect of a new mechanism on endothelin (ET) receptors in the physiopathology of diabetes-related pulmonary injury. We tested the hypothesis that dual ET-1 receptor antagonism via bosentan can reverse diabetes-induced lung injury. METHODS: The rats (24 male) were separated into four groups: group 1 (HEALTHY): Control group; group 2 (DM): Streptozotocin 60 mg/kg (i.p.); group 3 (DM + BOS-1): Diabetes + bosentan 50 mg/kg per-os; group 4 (DM + BOS-2): Diabetes + bosentan 100 mg/kg per-os. The bosentan treatment was initiated immediately after the onset of STZ-induced diabetes and continued for 6 weeks. RESULTS: In the treatment group, SOD activity was significantly increased, although GSH and MDA levels and TNF-α and TGF-ß gene expression were decreased. Bosentan 50 mg/kg and bosentan 100 mg/kg showed a significantly down-regulatory effect on ET-1, ET-A, and ET-B mRNA expression. CONCLUSIONS: In conclusion, increased endothelin levels in the lung associated with diabetes may be one cause of endothelial dysfunction, cytokine increase, and oxidant/antioxidant imbalance in the pathogenesis of complications that may develop during diabetes. With its multiple effects, bosentan therapy may be an effective option against complications that may develop in association with diabetes.

Comparative study on effects of nebulized and oral salbutamol on a cecal ligation and puncture-induced sepsis model in rats.

AIM: The present study aimed to compare the effects of different routes of salbutamol administration (oral and nebulized) at different doses in a cecal ligation and puncture-induced (CLP-induced) sepsis model of rats. METHODS: Rats were separated into 8 groups: 1) sham, 2) sham+4 mg/kg oral salbutamol, 3) sham+6 min 2 mg/ml nebulized salbutamol, 4) CLP, 5) CLP+2 mg/kg oral salbutamol, 6) CLP+4 mg/kg oral salbutamol, 7) CLP+3 min 2 mg/ml nebulized salbutamol, 8) CLP+6 min 2 mg/ml nebulized salbutamol. Subsequently, sepsis was induced by CLP through 16 h. RESULTS: CLP-induced sepsis increased serum cytokine levels (TNF-α, IL-1ß, and IL-6), increased tissue oxidative stress (8-Isoprosraglandin F2α), decreased antioxidant parameters (SOD, GSH), and increased lung injury by inflammatory cell accumulation. CONCLUSION: This study showed for the first time that oral administration of salbutamol exerted protective effects on CLP-induced sepsis and related lung injury in rats. We conclude that despite the greater side effects of oral salbutamol, it should be considered for administration in oral form due to its systemic effectiveness during septic conditions in emergency settings.

Dynamic light scattering and viscosity measurements in a ternary and quaternary discotic lyotropic nematic liquid crystal: tuning the backflow with salt.

Using a dynamic light scattering technique, we measure the damping rate of thermal fluctuations of the nematic director for the so-called disklike nematic N(D) phase of both the ternary lyotropic K-laurate-1-decanol-H(2)O system and the quaternary one of similar composition except for the addition of salt (K(2)SO(4)). By varying the scattering angle in suitable geometries and polarizations, we are able to measure the orientational diffusivities associated with the pure deformations of splay and twist. A previous study made in the N(D) phase of the same ternary system yielded a large deviation between the splay and twist diffusivities. The effect was then interpreted in terms of the anisotropy between their associated viscosities due to induced flows, or backflow. In the present work we observe a strong increase of the backflow as an effect of the added salt. In addition, we make auxiliary measurements of shear viscosity and magnetic instabilities, which help to characterize the effect of the salt in the orientational diffusivities as they are mixed quantities involving elastic constants and viscosity coefficients.

Lyotropic mixture made of potassium laurate/1-undecanol/K2SO4/water presenting high birefringences and large biaxial nematic phase domain: a laser conoscopy study.

The lyotropic liquid crystalline quaternary mixture made of potassium laurate (KL), potassium sulphate, 1-undecanol and water was investigated by experimental optical methods (optical microscopy and laser conoscopy). In a particular temperature and relative concentrations range, the three nematic phases (two uniaxial and one biaxial) were identified. The biaxial domain in the temperature/KL concentration surface is larger when compared to other lyotropic mixtures. Moreover, this new mixture gives nematic phases with higher birefringence than similar systems. The behavior of the symmetric tensor order parameter invariants σ (3) and σ (2) calculated from the measured optical birefringences supports that the uniaxial-to-biaxial transitions are of second order, described by a mean-field theory.

A multicenter case-control study of diagnostic tests for urinary tract infection in the presence of urolithiasis.

Urinary stone disease (USD) alone can cause much morbidity, but when present in conjunction with urinary tract infection, complications and morbidity increase even more. This study investigated the clinical and laboratory findings in patients who had USD with and without infection and evaluated the most suitable diagnostic value for urinary tract infection parameters before urine culture results were available. In a prospective fashion, patients who presented to the emergency department with a complaint of colicky flank pain (with or without hematuria) and who were diagnosed as having urolithiasis with ultrasound were evaluated for 1 year. The gold standard for the diagnosis of urinary tract infection was urine culture. The most suitable diagnostic value for urinary tract infection parameters was determined by receiver operating characteristic (ROC) curves. Logistic regression was used to identify independent variables that predicted a positive urine culture. Of the 192 eligible patients, 177 agreed to participate in the study. Of the clinical and laboratory characteristics analyzed, urine WBC, blood WBC, and fever were significantly different between culture positive and negative patients (p < 0.001, p = 0.04 p = 0.012, respectively). Using ROC curve analysis, pyuria (over 10 WBCs per HPF), fever over 37.9°C, and leucocytosis over 11,300 were the best predictors of a positive culture result. The logistic regression model for leukocytosis >11,300 (OR 2.1), pyuria (OR 2.8), and temperature >37.9°C (OR 3.1) showed a significantly increased risk of having a positive urine culture (correct class 87.9%). While a single physical examination or laboratory finding cannot predict urinary tract infection in USD patients with complete reliability, the presence of pyruria, fever, and leukocytosis significantly increases the odds of a positive urine culture.

An unusual cause of pelvic hemorrhage: multidetector CT diagnosis of inferior mesenteric vein injury.

Pelvic trauma can lead to uncontrollable bleeding and even death. Although significantly decreased with the application of novel treament modalities and the use of state-of-the-art imaging equipment, pelvic trauma and subsequent bleeding remains to stay as a major source of morbidity and mortality. In this case we present a patient suffering from pelvic bleeding from the inferior mesenteric vein due to sigmoid mesocolon injury. Similar finding has not been reported as an isolated source of pelvic hemorrhage. We also propose that the routine use of reformatted images obtained with multidetector CT scanners in patients with hemoperitoneum may be a highly useful adjunct for the correct identification of the source of hemorrhage.

Combined pancreas and en bloc kidney transplantation using a bladder patch technique from very small pediatric donors.

Very small pediatric donors are underutilized for pancreas and kidney transplantation for the fear of inadequate islet mass and higher incidence of technical complications, and the lower age limit for such donors is not well defined. We present here two cases of combined pancreas and en bloc kidney transplantation from very small pediatric donors (14 and 18 months old) to adult type 1 diabetic and uremic patients. The conventional surgical procedure for simultaneous pancreas and kidney transplantation with systemic venous and bladder exocrine drainage was successfully applied to very small organs. For both, we utilized the recently described bladder patch technique for ureteral reconstruction. One patient developed venous thrombosis (partial thrombosis of the splenic and mesenteric veins) and the other urine leak (from a midportion of the medial ureter without compromising the bladder patch) after the transplants; both were successfully managed and the patients demonstrated immediate and sustained pancreas and kidney graft functions for 12 and 2 months posttransplantation. These cases illustrate the feasibility of combined pancreas and en bloc kidney transplantation from very small pediatric donors using a bladder patch technique to avoid small ureteral anastomosis.

Mesenteric ischemia in a patient with Buerger's disease: MDCT findings.

Buerger's disease is a non-arteriosclerotic, segmental, inflammatory vascular occlusive disease, primarily affecting medium and small sized arteries of limbs. Mesenteric vascular involvement of this entity is a rarely seen manifestation. In this report, we present a case of Buerger's disease in which intestinal involvement was diagnosed by means of multi-detector CT.

The combination of amlodipine/valsartan 5/160 mg produces less peripheral oedema than amlodipine 10 mg in hypertensive patients not adequately controlled with amlodipine 5 mg.

AIMS: To demonstrate the benefit of the combination amlodipine/valsartan 5/160 mg over amlodipine 10 mg, in producing a lower incidence of peripheral oedema for a comparable mean sitting systolic blood pressure (MSSBP) reduction. METHODS: After a 4-week amlodipine 5 mg run-in phase, inadequately controlled hypertension patients (aged > or = 55 years, MSSBP > or = 130 and < or = 160 mmHg) were randomised to receive amlodipine/valsartan 5/160 mg or amlodipine 10 mg for 8 weeks, followed by amlodipine/valsartan 5/160 mg for 4 weeks for all patients. Primary variables were MSSBP change from baseline to week 8 and incidence of peripheral oedema reported as an AE. Resolution of peripheral oedema was assessed 4 weeks after switching patients from amlodipine 10 mg to amlodipine/ valsartan 5/160 mg. RESULTS: At week 8, MSSBP showed greater reduction with amlodipine/valsartan 5/160 mg than amlodipine 10 mg (least square mean: -8.01 vs.-5.95 mmHg, p < 0.001 for non-inferiority and p = 0.002 for superiority). Systolic control, overall BP control and systolic response rate at week 8 were significantly higher with combination than amlodipine 10 mg (34 vs. 26%; 57 vs. 50%; 36.57 vs. 27.77%, respectively). Incidence of peripheral oedema was significantly lower with the combination than amlodipine 10 mg (6.6 vs. 31.1%, p < 0.001). Peripheral oedema resolved in 56% patients who switched from amlodipine 10 mg to the combination, without the loss of effect on BP reduction. CONCLUSION: In non-responders to amlodipine 5 mg, treatment with amlodipine/valsartan 5/160 mg induced significantly less peripheral oedema than amlodipine 10 mg for similar BP reduction. Peripheral oedema resolved in > 50% patients switching from amlodipine 10 mg to the combination.

Hyperinfection strongyloidiasis in a liver transplant recipient treated with parenteral ivermectin.

Severe strongyloidiasis, including hyperinfection and dissemination, is a recognized complication of solid organ transplantation. However, the development of strongyloidiasis in a liver transplant recipient has not been previously described. We present a case of severe strongyloidiasis occurring in a patient 4 months after liver transplantation and 1 month after receiving treatment for acute rejection. We assess the management challenges in this patient who remained symptomatic despite oral treatment with ivermectin and albendazole and eventual successful treatment with parenteral ivermectin. We review the published experience with alternative methods of ivermectin administration. We also investigate the possible source of infection, as the patient was not from an endemic area.

MDCT of inferior mesenteric vein: normal anatomy and pathology.

Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.