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Adem Dirican,1 Sevket Ozkaya,2 Ali Ekber Atas,3 Esra Kayahan Ulu,4 Ilknur Kitapci,5 Ferah Ece21Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahçesehir University, Istanbul, Turkey; 3Department of Cardiology, Medical Park Samsun Hospital, Samsun, Turkey; 4Department of Radiology, Medical Park Samsun Hospital, Samsun, Turkey; 5Department of Intensive Care Unit, Medical Park Samsun Hospital, Samsun, TurkeyAbstract: Patients with pulmonary thromboembolism (PE) often decompensate suddenly, and once hemodynamic compromise has developed, mortality is extremely high. Currently, thrombolytic therapy for PE is still controversial. We retrospectively evaluated 34 patients with PE between January 2010 and December 2013 in the Department of Pulmonary Medicine, Medical Park Samsun Hospital, Samsun, Turkey. The demographic and disease characteristics of patients who received thrombolytic treatment were retrospectively analyzed. The female to male ratio was 19/15 and the mean age was 63.1±13.2 years. PE diagnosis was made using echocardiography (64.7%) or contrast-enhanced thorax computed tomography with echocardiography (32.4%). Twenty-two (64.7%) patients went into the cardiopulmonary arrest due to massive PE and 17 (50%) patients recovered without sequelae. Eleven (32.4%) patients were diagnosed with massive PE during cardiopulmonary arrest with clinical and echocardiographic findings. Alteplase (recombinant tissue plasminogen activator [rt-PA]) was administered during cardiopulmonary resuscitation (CPR) and four (36.3%) patients responded and survived without sequelae. The complications of rt-PA treatment were hemorrhage in five (14.7%) patients and allergic reactions in two (5.9%) patients. There was no mortality due to rt-PA treatment complications. In conclusion, mortality due to massive PE is much more than estimated and alteplase can be used safely in patients with massive PE. This thrombolytic treatment was not associated with any fatal hemorrhage complication. If there is any sign of acute PE, echocardiography should be used during cardiopulmonary arrest/instability. Alteplase should be given to patients with suspected massive PE.Keywords: massive pulmonary embolism, thrombolytic treatment, rt-PA, cardiopulmonary arrest, resuscitation, mortality, hemorrhage

Background: The aim of this study was to investigate the serum levels of anti-myelin basic protein (anti-MBP), anti-myelin oligodentrocyte glycoprotein (anti-MOG), myelin-associated glycoprotein (MAG), high-sensitivity C-reactive protein (hs-CRP), cerebral dopamine neurotrophic factor (CDNF), cerebellin-1, and reelin and their relationships with clinical severity and irritability behaviours in children with attention deficit (AD) hyperactivity disorder (ADHD) and typically developing (TD) healthy controls., Methods: In this study, 141 children with ADHD between the ages of 8 and 14 years who were medication-free and 135 TD healthy controls were included. The serum levels of anti-MBP, anti-MOG, MAG, CDNF, hs-CRP, cerebellin, and reelin were measured using enzyme-linked immunosorbent assay kits. The Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-based Screening and Evaluation Scale for Attention Deficit and Disruptive Behavior Disorders-Parent Form (TDSM-IV-O) and the affective reactivity index (ARI) scale were used to assess clinical severity and irritability behaviours in the children., Results: The MAG, CDNF, hs-CRP, reelin, and cerebellin levels were significantly higher in the ADHD group than in the control group, but no significant differences in anti-MBP and anti-MOG levels were found between the groups. Compared with the controls, the patients with ADHD showed significantly higher scores on the ARI self- and parent-report scales. The reelin, hs-CRP, and MAG levels were significantly associated with the TDSM-IV-O AD scores, AD and oppositional defiant (OD) disorder scores and hyperactivity, and OD and conduct disorder scores, respectively. Hs-CRP was significantly associated with anti-MBP and cerebellin levels. In an analysis of covariance, the results were unchanged even after controlling for potential confounders such as age, body mass index, and sex., Conclusion: This study demonstrates that MAG, CDNF, hs-CRP, reelin, and cerebellin levels may play a potential role in the pathogenesis of ADHD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: The distinction between benign and borderline epithelial ovarian tumors is important because treatment and follow-up strategies differ, Objective: We aimed to evaluate benign, borderline, and malignant epithelial ovarian tumors using MRI features and contributed to the preoperative evaluation., Methods: MRIs of 81 patients (20 bilateral), including 31 benign, 27 borderline, and 23 malignant, who had pelvic imaging between 2013-2020, were evaluated retrospectively. The evaluation was made blindly to the pathology result by two radiologists with MRI scoring and features that we determined. MRI evaluation was performed with T1 TSE, T2 TSE, fat-suppressed T2 TSE, and before and after contrast T1 fat-suppressed and non-fat-suppressed TSE images. The numbers and findings obtained in scoring were evaluated by Chi-Square, ordinal logistic regression, and 2 and 3 category ROC analysis., Results: The total score varied between 7 and 24. Among the three groups, a significant difference was found in terms of T1, T2 signal intensity (p <0.01), size (p = 0.055), solid area (p <0.001), septa number (p <0.05), ovarian parenchyma (p = 0.001), ascites (p <0.001), peritoneal involvement (p <0.001), laterality (p <0.001), contrast enhancement pattern (p <0.001). On the other hand, no significant difference was found in terms of wall thickness, lymph node involvement and endometrial thickness (p> 0.05). Cut-off values were found as 11.5 and 18.5 in the 3-category ROC analysis performed for the score (VUS: 0.8109). Patients with a score below 11.5 were classified as benign, those between 11.5-18.5 as borderline, and those over 18.5 as malignant., Conclusion: The differentiation of borderline tumors from benign and malignant tumors by MRI scoring will contribute to the preoperative diagnosis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)