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Ultrasound elastography is a simple non-invasive method for measuring tissue elasticity in relation to tissue fibrosis. The aim of this study was to compare echogenicity, volume and shear wave velocities of undescended vs normally descended testes.

Objectives: To determine whether idiopathic intracranial hypertension (IIH) may affect white matter integrity and optic pathways by using diffusion tensor imaging (DTI) and to correlate the DTI metrics with intracranial pressure (ICP). Methods: This study is a retrospective case–control study. A total of 42 patients who underwent lumbar puncture and those with elevated ICP, meeting the diagnostic criteria for IIH, were included in the study. All patients had supportive magnetic resonance imaging findings for the diagnosis of IIH. The headache control group comprised 36 patients who presented to the Neurology Department with infrequent episodic tension‐type headache, had a normal neurologic examination, and had clinical and radiological findings suggestive of normal ICP. For each patient with IIH, clinical findings and ophthalmological measurements were recorded. The apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) values were calculated using a region of interest‐based method in different white matter tracts and optic pathways and compared. Results: A total of 42 patients diagnosed with IIH (three males, 39 females), with a mean (standard deviation [SD] age of 38.1 (8.9) years), and 36 headache controls (10 males, 26 females, mean [SD] age; 38.1 [9.4] years) were included in the study. The mean (SD) body mass index (BMI) of the patients with IIH was 25.2 (1.9) kg/m2, and the mean (SD) BMI of the headache controls was 23.3 (1.5) kg/m2 (p < 0.001). Decreased FA values and increased RD values in the cingulum were detected in patients with IIH compared to the headache controls (p = 0.003, Cohen's d = 0.681; p = 0.002 Cohen's d = −0.710). Decreased AD values in the left and right superior cerebellar peduncle and increased ADC values in the middle cerebellar peduncle were detected in patients with IIH compared to the headache controls (p < 0.001, Cohen's d = 0.961; p = 0.009, Cohen's d = 0.607; p = 0.015, Cohen's d = −0.564). Increased ADC and RD values and decreased FA values in optic nerve were detected in patients with IIH (p = 0.010, Cohen's d = −0.603; p = 0.004, Cohen's d = −0.676; p = 0.015 Cohen's d = 0.568). A positive correlation was found between the cerebrospinal fluid pressure and ADC values of the left and right superior and left inferior longitudinal fasciculus, genu of the corpus callosum, and right optic radiation (r = 0.43, p = 0.005; r = 0.31, p = 0.044; r = 0.39, p = 0.010; r = 0.35, p = 0.024; r = 0,41, p = 0.007). There was a positive correlation between the retinal nerve fiber layer thickness and the ADC values of the optic nerve (r = 0.32, p = 0.039). Conclusions: Intracranial hypertension can be associated with deteriorated DTI values, which might be interpreted as a sign of impaired white matter microstructural integrity in many brain regions beyond the periventricular white matter. Pressure‐induced edema and axonal degeneration may be the potential underlying mechanisms of this microstructural damage. Plain Language Summary: Females of reproductive age with obesity are disproportionately affected by idiopathic intracranial hypertension (IIH), and the incidence of this diagnosis is increasing along with the prevalence of obesity. We do not yet understand how IIH develops, but dysregulation of intracranial pressure is an important area of research interest, so we hypothesized that increased intracranial pressure may affect white matter microstructure and optic pathways in patients with IIH. Using data from a specialized imaging technique, we found that patients with IIH may have impaired white matter microstructural integrity in several areas of the brain and microstructural alterations in the optic nerve. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the restoration of the natural hip biomechanics, a successful total hip arthroplasty (THA) and long-term survival is pursued. Although robotic THA (rTHA) has been developed to increase accuracy of implant positioning, leg lengths and offsets, discussions about its radiological and clinical advantages over conventional THA (cTHA) continues. OBJECTIVE: The aim of this study was to compare clinical and radiological outcomes of robotic and conventional THA. METHODS: This retrospective study compares functional and radiological outcomes of 82 rTHA with a matched group of 82 cTHA in terms of age, sex, body mass index and preoperative functional scores. The minimum follow up was 12 months for all patients. Functional outcomes were Harris Hip Score (HHS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) evaluated pre- and postoperatively. Radiological evaluations included position of cup placement according to Lewinnek and Callanan safe zones, Canal Fill Ratio (CFR), Leg Length Discrepancy (LLD), Lateral offset (LO) and Femoral Component Alignment (FCA). Complications were also evaluated. RESULTS: In the rTHA group, 91.5% (75 out of 82) of the acetabular cups were positioned within the safe zone whereas it was 63.4% (52 out of 82) for the cTHA group (p < 0.001). According to Callanan, they were 84.1% and 50%, respectively (p < 0.001). Between the groups, no statistically significant difference was found in CFR, LLD, HO, FCA, AI, AA, WOMAC, HHS and major complication rates. CONCLUSION: rTHA is superior to cTHA in terms of accuracy and reproducibility of the cup placement, however no apparent clinical benefit was found in short term follow. [ABSTRACT FROM AUTHOR]

Intraoperative consultation (IC) is often used for surgical planning in gynecological oncology, primarily in ovarian and endometrial cancer surgery. However, there is limited research that compares IC diagnoses and results from definitive analyses. This retrospective study compares IC results and definitive analysis findings in terms of ovarian mass diagnoses and endometrial carcinoma patients consulted for myometrial invasion (MI) depth across 7 years (2012-2019). IC was performed in 282 cases to evaluate ovarian masses. The sensitivity of IC was 94% for benign ovarian masses and 90% for malignant ovarian masses. 92 cases were submitted to IC for endometrial carcinoma. Sensitivity was 80% for tumors with <50% MI and 74% for tumors with ≥50% MI. IC is an important method with high sensitivity and specificity for diagnosing ovarian masses and determining MI depth in endometrial carcinomas. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the difference in FA (Fractional anisotropy), ADC (Apparent diffusion coefficient), RD (Radial diffusivity) and AD (axial diffusivity) values of white matter (WM) tracts in morbidly obese subjects before and after bariatric surgery (BS). Materials and Methods: A group of thirty‐nine morbidly obese subjects are evaluated before and 4–6 months after BS. ADC, FA, RD and AD values of 17 distinct neuroanatomic localizations are measured and DTI parameters are analyzed. Results: Following the BS, the patients' mean BMI decreased from 47.665.21 to 31.723.97. A significant difference is displayed between the pre‐surgery and post‐surgery FA values of SLF, SFOF, ALIC, fornix, ILF, CST, MCP (p = 0.010, p < 0.001, p = 0.048, p = 0.014, p = 0.012, p = 0.012, p = 0.040 respectively). Following BS, decrease in FA values in the mentioned areas are detected. ADC values obtained from MCP are significantly lower in the post‐BS period compared to pre‐BS period (p = 0.018). There was a statistically significant difference between the pre‐surgery and post‐surgery AD values of SLF, SFOF, ILF, ALIC, EC, CST, and MCP (p = 0.001, p = 0.022, p = 0.001, p = 0.011, p = 0.001, p = 0.000, p = 0.000, respectively). Following the BS, AD values of the SLF, SFOF, ILF, ALIC, EC, CST, and MCP are decreased. RD values measured from GCC are significantly lower in the post‐BS period compared to pre‐BS period (p = 0.008). Conclusion: Our study supported the hypothesis of the BS‐induced reversibility of the low‐grade inflammation in WM tracts in the morbidly obese group following BS. Our DTI results may represent the subacute period findings of the reversal of low‐grade inflammation after BS. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether the diffusion tensor imaging (DTI) parameters alterations in the in hypoxia‐related neuroanatomical localizations in patients after COVID‐19. Additionally, the relationship between DTI findings and the clinical severity of the disease is evaluated. Methods: The patients with COVID‐19 were classified into group 1 (total patients, n = 74), group 2 (outpatient, n = 46), and group 3 (inpatient, n = 28) and control (n = 52). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from the bulbus, pons, thalamus, caudate nucleus, globus pallidum, putamen, and hippocampus. DTI parameters were compared between groups. Oxygen saturation, D dimer and lactate dehydrogenase (LDH) values associated with hypoxia were analyzed in inpatient group. Laboratory findings were correlated with ADC and FA values. Results: Increased ADC values in the thalamus, bulbus and pons were found in group 1 compared to control. Increased FA values in the thalamus, bulbus, globus pallidum and putamen were detected in group 1 compared to control. The FA and ADC values obtained from putamen were higher in group 3 compared to group 2. There was a negative correlation between basal ganglia and hippocampus FA values and plasma LDH values. The ADC values obtained from caudate nucleus were positively correlated with plasma D Dimer values. Conclusion: ADC and FA changes may reveal hypoxia‐related microstructural damage after COVID‐19 infection. We speculated that the brainstem and basal ganglia can affected during the subacute period. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the relationship between anxiety and skeletal muscle index (SMI) levels in lung cancer patients on the first day of chemotherapy. Materials & methods: This cross-sectional study included 108 patients. We analyzed patient characteristics, SMI levels, pain status and predicted anxiety factors. Results: Anxiety was detected in 61% of patients. SMI levels were significantly lower in the high anxiety group than the low anxiety group (p < 0.001). A significant correlation was observed between anxiety and SMI levels (r = -0.292; p = 0.002). Anxiety levels were significantly correlated with trait anxiety (r = 0.618; p < 0.001) and visual analog scale–pain (r = 0.364; p < 0.001). SMI (odds ratio: 0.94), trait anxiety (odds ratio: 1.12) and visual analog scale pain (odds ratio: 1.28) were independent risk factors for anxiety after adjusting for sex, stage and Eastern Cooperative Oncology Group performance status. Conclusion: Our study highlighted that higher anxiety scores were significantly correlated with lower SMI levels. We found that SMI, pain and trait anxiety were independent risk factors for anxiety. [ABSTRACT FROM AUTHOR]

The article discusses the effects of idiopathic intracranial hypertension (IIH) on the brain's white matter and optic nerve, highlighting changes associated with increased pressure inside the skull. Topics include diffusion tensor imaging techniques, the relationship between increased intracranial pressure and brain damage, and the potential for improved treatment strategies for IIH.

Introduction: The lymphoid enhancer factor 1 (LEF1) is a DNA‐binding transcription factor that functions in the Wnt signaling pathway. Increased LEF1 activity is associated with progression of several types of cancer including leukemia. Here, we investigated LEF1 isoform expression and genomic variations in acute lymphoblastic leukemia (ALL). Methods: LEF1 isoform expression was evaluated by quantitative real‐time PCR in 87 newly diagnosed childhood ALL patients and controls. Moreover, Western blot analysis was performed for detection of LEF1 expression and the hotspot region of LEF1 was screened by deep sequencing. Results: The LEF1 mRNA expression of B cell ALL patients was higher than the controls (LEF1‐total P =.011, LEF1‐long P =.026). Moreover, B‐ALL samples showing higher total LEF1 expression had significantly shorter relapse‐free survival (P =.008) and overall survival (P =.011). Although full‐length LEF1 expression was similar to the controls in T‐ALL, 50% (n = 15) of the ALL patients had increased full‐length LEF1 protein expression. Imbalance between short‐ and full‐length LEF1 isoforms may lead to cell survival in ALL. Beside the LEF1 activation, LEF1 gene variations were rarely observed in our cohort. Conclusion: The results indicate that the Wnt pathway may have a pathogenic function in a group of ALL patients and high LEF1‐total expression might be a marker for shorter relapse‐free survival time in B cell ALL. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to investigate whether white matter (WM) integrity is impaired in vitamin B12 and folate deficiency with Diffusion Tensor Imaging (DTI) in older patients. Methods: All the patients aged ≥65 years admitted to the geriatric clinic and performed DTI‐MRI were included in the study. DTI parameters (fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity) were calculated by ROI‐based method in white matter tracts. Deficiency threshold for vitamin B12 were defined as <200 pg ml−1 and <400 pg ml−1 separately; and for folate as <3 ng ml−1 and <6 ng ml−1, separately. Results: DTI was performed to older patients having serum vitamin B12 level (n = 106, mean age = 80.7±7.7, 66% female) and folate level (n = 101, mean age = 80.7±7.5, 67.3% female). Significantly lower FA and higher MD and RD levels were observed in multiple WM areas including superior and middle cerebellar peduncles, cingulum and genu of corpus callosum in patients with vitamin B12 <400 pg ml−1 (p < 0.05). DTI indices also showed significant changes in the genu of corpus callosum, and right and left superior longitudinal fasciculus in patients with folate <6 ng ml−1 (p < 0.05). Conclusions: Deficiencies of vitamin B12 and folate may be associated with impaired white matter integrity in elderly even at high laboratory levels, and DTI is a useful method to detect it. Advances in knowledge: Early detection of impaired WM integrity caused by micronutrient deficiencies poses a great significance in terms of prevention and intervention, and DTI is an effective non‐invasive method to be used for this purpose. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the attitudes and knowledge of adult individuals about antibiotics. Since in Turkey, antibiotics are not sold without a prescription, it was also investigated whether Turkish people compelled physicians to prescribe antibiotics by showing unrealistic symptoms. Methods: A self-administered cross-sectional survey involving 1,057 respondents was conducted using a validated questionnaire. The questionnaire was prepared in four sections. The first section included attitude assessment and a five-point Likert scale has collected information. In the second section, knowledge questions examined participants' knowledge about antibiotics with Three-point Likert scale. The third section contained a sensitive question, and using the crosswise model was indirectly asked whether the participant has forced the physician to prescribe an antibiotic. The reliability test results for the attitude scale showed the α-value of Cronbach was 0.767, and KR-21 reliability for the knowledge scale was 0.713. Test-retest reliability coefficients for attitude scale was r=0.697, the coefficients for knowledge scale was r=0.887. Results: Turkish people's awareness about antibiotics is insufficient but at an acceptable level. The public is aware that antibiotics rapidly develop resistance when used widely and incorrectly. Nevertheless, %17 of them resort to showing unrealistic symptoms to force the physician to prescribe antibiotics. Conclusion: To conclude, Turkish people's knowledge and attitudes about antibiotics are insufficient but acceptable. However, a noticeable rate of patients resorts to showing unrealistic symptoms to force the physician to prescribe antibiotics. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between intraprostatic 68Ga-prostate-specific membrane antigen (PSMA) uptake values and volumetric parameters derived from early pelvic and standard-time whole-body 68Ga-PSMA PET/computed tomography (CT) images in untreated prostate cancer (PCa) patients, and to assess the predictive significance of these data in relation to disease prognosis, comparing them with the Gleason score, clinical risk classification and the presence of metastatic disease detected in 68Ga-PSMA PET/CT imaging., Methods: Eighty-one newly diagnosed PCa patients underwent early phase pelvic imaging at the 5th minute and standard time whole-body imaging at the 60th minute. Various threshold values were used in intraprostatic delineations to compute maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), intraprostatic PSMA tumor volume and intraprostatic total lesion PSMA uptake. Correlations between early and standard time measurements, as well as changes in SUV parameters over time, were examined. The association of these values with Gleason score, clinical risk status (National Comprehensive Cancer Network), and metastatic disease was explored., Results: SUVmax measurements from both early and standard time images distinguished all three groups (clinical risk scores, Gleason score and metastatic group), with standard imaging demonstrating statistical superiority in receiver operating characteristic analyses. Strong correlations were observed between early and standard-time PET parameters. Changes in intraprostatic SUVmax and SUVmean values over time did not exhibit predictive value., Conclusion: Although intraprostatic PSMA PET parameters generally aligned at both early and standard times, parameters obtained from standard time images showed more robust correlations with clinical risk scores, Gleason score and metastasis status in newly diagnosed, untreated PCa patients., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negative but assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings., Methods: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngeal swabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodies were analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, the patients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as <5% lung involvement versus ≥5% lung involvement., Results: The patients' mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgG positive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases (p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively)., Conclusion: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgG antibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lung parenchymal involvement.