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Objectives: The aim of this study was to investigate the role of superb microvascular imaging (SMI) and shear wave elastography (SWE) in the prediction of malignancy and invasiveness of isolated microcalcifications (MC) that can be visualized by ultrasonography (US). Material and Methods: Sixty‐seven women with MC, who were considered suspicious on mammography were evaluated. Only those lesions that could be visualized by US and presented as non‐mass lesion were included. They were evaluated by B‐mode US, SMI, and SWE before US‐guided core‐needle biopsy. B‐mode US, SMI (vascular index (SMIvi)), and SWE (E‐mean, E‐ratio) findings were compared with histopathologic features. Results: Pathology confirmed 45 malignant (21 invasive and 24 in situ carcinomas) and 22 benign lesions. There was a statistically significant difference between malignant and benign groups in terms of size (P =.015), distortion (P =.028), cystic component (P <.001), E‐mean (P <.001), E‐ratio (P <.001), and SMIvi (P =.006). For differentiation of invasiveness E‐mean (P =.002), E‐ratio (P =.002), and SMIvi (P =.030) were statistically significant. According to ROC analysis E‐mean (cut‐off point at 38 kPa) was the most sensitive (78%) and the most specific (95%) value among four numeric parameters (size, SMI, E‐mean, and E‐ratio) with AUC = 0.895, PPV = 97%, and NPV = 68% in detecting malignancy. In the evaluation of invasiveness, the most sensitive (71.4%) method was SMI (cut‐off point at 3.4) and the most specific (72%) method was E‐mean (cut‐off point at 91.5 kPa). Conclusion: Our study shows that adding SWE and SMI to the sonographic evaluation of MC would be an advantage for US‐guided biopsy. Including suspicious areas according to SMI and SWE in the sampling area can help target the invasive part of the lesion and avoid underestimation of core biopsy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the strength of quantitative imaging and metabolic parameters in differentiating invasive breast carcinomas with elevated Ki‐67 levels. Materials and Methods: A total of 123 patients with 129 breast lesions confirmed as invasive breast carcinoma underwent shear wave elastography (SWE), superb microvascular imaging (SMI) and positron emission tomography (PET)/CT or MRI. Adler's grade (classifying the microvascularity into four types) and Vascular Index (VI) was obtained by SMI as microvascular parameters. In addition, the stiffness value (Emean) was evaluated in kilopascal by SWE. The average of consecutive measurements was recorded as mean VI and mean Emean. PET scan parameters were obtained as SUVmax and SULpeak. Lesions were divided into two groups according to the Ki‐67 expression, low as ≤14 and high as >14. Results: Adler's grading was the most correlated imaging parameter with high Ki‐67 expression (p < 0.05), while VI and Emean had poor correlation (p > 0.05). SUVmax and SULpeak indicated a significant linear correlation with Ki‐67 but a moderate correlation with the high levels of Ki‐67 (p < 0,001). The sensitivity of VI, Emean, SUVmax and SULpeak was 64.6%, 66.7%, 65.7%, and 66.7% when the cut‐off point was set to 5.25, 102.5, 6.59, and 2.63, respectively. SUVmax had the highest AUC value of 0.740, according to the ROC curve analysis. Conclusions: Our results suggest that the quantitative parameters obtained by advanced imaging methods may be useful in predicting the high proliferation in invasive breast carcinomas. But none of them is eligible to be used as an independent biomarker in distinguishing aggressive behavior. Nevertheless, as a noninvasive method, visual assessment of microvascular morphology using SMI increases the prognostic efficiency in invasive breast carcinomas. [ABSTRACT FROM AUTHOR]

Background: Povidone‐iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG‐IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use. Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018–March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid‐stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects. Results: We enrolled 208 term and preterm infants (PI:104 vs. CHG‐IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG‐IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG‐IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG‐IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG‐IA solution. Conclusions: Although these two solutions were equally protective against infections, the CHG‐IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG‐IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile. [ABSTRACT FROM AUTHOR]

Background: Parenteral nutrition (PN) has been widely used in preterm infants. The lipid solutions used for PN, however, are associated with oxidative stress and morbidity. The aim of this study was to compare the effectiveness of a new‐generation lipid emulsion (SMOFLipid) and olive‐oil based lipid emulsion for prevention of PN‐associated oxidative damage. Methods: Preterm infants < 32 weeks of gestational age were included in this prospective randomized study. All infants were randomized to SMOFlipid or olive‐oil based lipid emulsion (ClinOleic). Lipid peroxidation products were evaluated in all infants. In addition, total antioxidant capacity (TAC), and both pro‐ and anti‐inflammatory cytokines were studied at days 0, 7 and 14. Results: A total of 89 infants (SMOFlipid, n = 42; ClinOleic, n = 47) were enrolled. TAC was higher in the SMOFlipid group compared with the ClinOleic group at all time points, and the difference on day 7 was statistically significant. Although the anti‐inflammatory cytokine interleukin‐10 was higher in the SMOFlipid group, this difference was not significant. Bronchopulmonary dysplasia (BPD) was lower in the SMOFlipid group (14.1%) than in the ClinOleic group (31.2%), but this finding was non‐significant p > 0.05. The rate of severe BPD was significantly lower in the SMOFlipid group. Conclusion: To our best of knowledge, this is the first study to suggest that SMOFlipid might decrease oxidative damage and oxidative‐stress‐associated morbidity compared with olive oil‐based emulsion in preterm infants. [ABSTRACT FROM AUTHOR]