Search

BACKGROUND Colloid cysts are an unusual differential diagnosis for lesions in the lateral ventricles. Microsurgery is usually recommended for the treatment of giant colloid cysts. This case is the largest reported colloid cyst in this unusual location treated with an endoscope. OBSERVATIONS A 39-year-old woman with a history of pulsing headaches presented with nausea, vomiting, vision blurring, and paresthesia of the left leg. On the brain computed tomography, a huge, well-defined homogeneous hyperdense intraventricular lesion with hydrocephalus was observed. Magnetic resonance imaging showed a spherical lesion over the third ventricle inside the lateral ventricles, obstructing the Sylvius aqueduct. There was no enhancement and no diffusion restriction on diffusion-weighted images. Endoscopic third ventriculostomy was undertaken for hydrocephalus treatment. Then the lesion was resected grossly. The cyst wall was resected as much as it was safe. There was no clot or bloody product inside the lesion. LESSONS Colloid cyst is rarely encountered in the velum interpositum and lateral ventricles, but the authors’ giant colloid cyst case along with similar cases led to considering it out of the third ventricle. According to their experience, endoscopic removal is a safe and efficient method for colloid cyst surgery, even in giant cases.

Despite the globally reducing hospitalization rates and the much lower risks of Covid-19 mortality, accurate diagnosis of the infection stage and prediction of outcomes are clinically of interest. Advanced current technology can facilitate automating the process and help identifying those who are at higher risks of developing severe illness. Deep-learning schemes including Visual Transformer and Convolutional Neural Networks (CNNs), in particular, are shown to be powerful tools for predicting clinical outcomes when fed with either CT scan images or clinical data of patients.This paper demonstrates how a novel 3D data fusion approach through concatenating CT scan images with patients’ clinical data can remarkably improve the performance of Visual Transformer and CNN models in predicting Covid-19 infection outcomes. Here, we explore and represent comprehensive research on the efficiency of Video Swin Transformers and a number of CNN models fed with fusion datasets and CT scans only vs a set of conventional classifiers fed with patients’ clinical data only. A relatively large clinical dataset from 380 Covid-19 diagnosed patients was used to train/test the models. Results show that the 3D Video Swin Transformers fed with the fusion datasets of 64 sectional CT scans+67 (or 30 selected) clinical labels outperformed all other approaches for predicting outcomes in Covid-19-infected patients amongst all techniques (i.e., TPR=0.95, FPR=0.40, F0.5 score=0.82, AUC=0.77, Kappa=0.6). Results indicate possibilities of predicting the severity of outcome using patients’ CT images and clinical data collected at the time of admission to hospital.

Background: Iatrogenic femoral artery pseudoaneurysm, a rare but significant complication, could be managed by ultrasound-guided compression. This study decided to evaluate the success rate of this method and the risk factors associated with failure.Methods: In this cross-sectional study performed in two university hospitals, all patients who developed pseudoaneurysm of the femoral artery after coronary angiography for six years (2013 to 2018) and underwent ultrasound-guided compression by a vascular surgeon were included. Necessary information, including gender, age, body mass index (BMI), pseudoaneurysm neck diameter, diabetes, hypertension, smoking, anemia, and coronary heart disease, were collected. Then, the success rate of the treatment was evaluated, and the risk factors associated with failure were determined using the regression analysis.Results: Forty-five patients (25 males and 20 females) with a mean age of 61.6 years developed the complication. Treatment was successful in 32 patients (71.1%) but failed in 13 patients (28.9%). Logistic regression results showed that BMI ≥ 30 kg/m2 (OR (odds ratio)= 5.7, 95% CI: 1.2 to 26.6, P= 0.02) and pseudoaneurysm neck diameter of ≥ 4 mm (OR= 6.3, 95% CI: 1.3 to 31.3, P= 0.02) significantly associated with treatment failure. Conclusion: Obesity (BMI ≥ 30) and neck diameter of ≥ 4 mm were significant risk factors for failure of ultrasound-guided compression of femoral artery pseudoaneurysm. Taking more precautions in patients who have these two risk factors may help reduce the failure rate of this technique.

Purpose Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease which has become a public health concern, whose growing prevalence has been reported as around 33.9% in Iran. As oxidative stress plays a crucial role in the pathogenesis of NAFLD, antioxidant compounds such as quercetin could ameliorate the side effect of oxidative stress. The aim of the current study was to assess the effect of quercetin on lipid profile, liver enzymes and inflammatory indices in NAFLD patients. Design/methodology/approach In a randomized, double-blind, placebo-controlled trial conducted as a pilot study, 90 patients with NAFLD were supplemented with either a quercetin or a placebo capsule twice daily (500 mg) for 12 weeks. Both groups were advised to follow an energy-balanced diet with physical activity recommendations. Blood sample was obtained for laboratory parameters at baseline and the end of week 12. Findings At the end of the follow-up, quercetin group had significantly greater reduction in anthropometric parameters, cholesterol (−15 ± (−41, 0.00) in Q group versus −1± (−8, 2) in control group, p = 0.004), TG (−56.7 ± 22.7) in Q group versus −13.4 ± 27.7 in control group, p = 0.04), and tumor necrosis factor-α (TNF-α) (−49.5 ± (−99, 21) in Q group versus −5 ± (−21, 0.30) in the control group, p < 0.0001) compared to the control group. However, changes in fatty liver grade, liver enzymes, as well as high density lipoprotein-cholesterol and high-sensitivity C-reactive protein were not significantly different between the two groups. Originality/value To the best of the authors’ knowledge, this was the first study which assessed the effect of quercetin supplementation on liver enzymes, lipid profile and inflammatory indices of NAFLD patients as a double-blind placebo-controlled pilot study.