Search

Background: Due to the high mortality of lung cancer, the aim was to find convolutional neural network models that can distinguish benign and malignant cases with high accuracy, which can help in early diagnosis with diagnostic imaging., Methods: Patients who underwent tomography in our clinic and who were found to have lung nodules were retrospectively screened between January 2015 and December 2020. The patients were divided into two groups: benign (n=68; 38 males, 30 females; mean age: 59±12.2 years; range, 27 to 81 years) and malignant (n=29; 19 males, 10 females; mean age: 65±10.4 years; range, 43 to 88 years). In addition, a control group (n=67; 38 males, 29 females; mean age: 56.9±14.1 years; range, 26 to 81 years) consisting of healthy patients with no pathology in their sections was formed. Deep neural networks were trained with 80% of the three-class dataset we created and tested with 20% of the data. After the training of deep neural networks, feature extraction was done for these networks. The features extracted from the dataset were classified by machine learning algorithms. Performance results were obtained using confusion matrix analysis., Results: After training deep neural networks, the highest accuracy rate of 80% was achieved with the AlexNET model among the models used. In the second stage results, obtained after feature extraction and using the classifier, the highest accuracy rate was achieved with the support vector machine classifier in the VGG19 model with 93.5%. In addition, increases in accuracy were noted in all models with the use of the support vector machine classifier., Conclusion: Differentiation of benign and malignant lung nodules using deep learning models and feature extraction will provide important advantages for early diagnosis in radiology practice. The results obtained in our study support this view., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Cardiovascular Surgery.)

Background: This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver. Background: This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver., Methods: Between January 2012 and August 2023, a total of 138 hydatid cysts were retrospectively analyzed. There were 55 pulmonary (32 males, 23 females; mean age: 25.6±23.8 years; range, 2 to 77 years) and 83 hepatic hydatid cyst patients (32 males, 51 females; mean age: 31.1±22.8 years; range, 3 to 75 years)., Results: The mean doubling times for pulmonary and hepatic hydatid cysts were 73.4±41.8 and 172.6±108.8 days, respectively (p<0.001). When children (≤18 years old) and adult cases were compared for pulmonary hydatid cysts, the mean doubling times were 61.1±17.6 and 87.1±55.3 days, respectively (p=0.119), and for hepatic hydatid cysts, 110.6±48.4 and 215.6±118.3 days, respectively (p<0.001). While comparing male and female cases, the mean doubling time for pulmonary hydatid cysts was 77.6±32.2 and 67.6±52.6 days, respectively (p=0.018), while for hepatic hydatid cysts, it was 192.0±111.7 and 160.4±106.2 days, respectively (p=0.250)., Conclusion: The doubling time seems to be approximately 10 weeks in the lung and approximately 25 weeks in the liver. Hydatid cysts grow faster in children than adults in both the lungs and liver., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Cardiovascular Surgery.)

Purpose: This study is to investigate the effectiveness of Acoustic Radiation Force Impulse (ARFI) elastography in differentiating radiologically similar renal cell carcinoma (RCC) and oncocytoma in solid masses of the kidney., Methods: The patients with solid renal mass histopathological diagnosed after excision or tru-cat biopsy who underwent a preoperative ARFI elastography of the lesion during a 4-year period were included in this study. Preoperative shear wave velocity (SWV) values were measured in all the lesions. SWV results of RCCs and oncocytomas were compared by an independent t-test, and cut-off, sensitivity and specificity values were calculated., Results: Forty-two of the 60 patients included in the study were men (70%) and, 18 were women (30%), and the mean age was 59.7 ± 14 (27-94) years. Among 46 RCCs (76.6%), 23 and 14 oncocytomas, 5 (23.4%) were located in the right kidney (p:0.34722). Mean SWV values were found to be significantly higher in RCCs (2.87± 0.74 (0.96-4.14) m/s) than oncocytomas (1.83 ± 0.78 (0.80-3.76) m/s) (p <0.001). In the ROC analysis, a cutoff value of 2.29 m/s was found to havean 80.4% sensitivity and a 78.6% specificity for the discrimination of RCCs from oncocytomas., Conclusion: ARFI elastography measurements may be useful in distinguishing RCC and oncocytomas that may have similar solid radiological imaging features., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In this study, further treatment of coking wastewater treated in anoxic-oxic-membrane bioreactor (A 2 O-MBR) was investigated to meet the standards of the ministry by means of nanofiltration (NF) (with two different membranes and different pressures), microfiltration -powder activated carbon (MF-PAC) hybrid system and NF-PAC (with two different membranes and five different PAC concentrations) hybrid system. In addition to the parameters determined by the ministry, other parameters such as ammonium, thiocyanate (SCN - ), hydrogen cyanide (HCN), dissolved organic carbon (DOC), dissolved inorganic carbon (DIC), color were also examined to evaluate the flux performance and treatment efficiency of the hybrid processes. According to the results, chemical oxygen demand (COD) in the NF process, COD and total cyanide (T-CN) in the MF-PAC process could not meet the discharge standards. As for the NF-PAC hybrid system, XN45 membrane met the discharge standards in all parameters (COD = 96±1.88 mg/L, T-CN =<0,02 mg/L, phenol =<0.05 mg/L), with a recovery rate of 78% at 0.5 g/L PAC concentration., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Purpose: This study aims to compare chest computed tomography (CT) findings between adult and pediatric patients with coronavirus disease-19 (COVID-19) pneumonia., Materials and Methods: This study included 30 pediatric patients aged 1 to 17 years and 30 adult patients over 18 years of age with COVID-19 pneumonia confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) who have findings related to COVID-19 on Chest Computed Tomography. The CT findings of adult and pediatric patients were compared with a z-test., Results: Bilateral involvement (p:0.00056), involvement in all five lobes (p<0.00001), and central and peripheral involvement (p:0.01928) were significantly higher in the adult group compared to the pediatric group. In the pediatric group, the frequency of unilateral involvement (p:0.00056), involvement of solitary lobe (p:0.00132), and peripheral involvement (p: 0.01928) were significantly higher than in the adult group. The most common parenchymal finding in adults and pediatric patients was ground-glass opacities (100% and 83%, respectively). Among the parenchymal findings in adults, ground-glass opacities with consolidation (63%) were the second most common finding, followed by air bronchogram (60%) in adults, while in pediatric patients, halo sign (27%) and nodule (27%) were the second most common, followed by the ground-glass opacities with consolidation (23%)., Conclusion: The CT findings of pediatric COVID-19 patients must be well-known as the course of the disease is usually less severe, and the radiological findings are uncertain when compared with adults., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Abstract: This preliminary study aimed to evaluate the possible damage to the male reproductive system that the severe acute respiratory syndrome coronavirus 2 virus causes by quantitatively measuring and comparing the tissue stiffness of the testis and epididymis with acoustic radiation force impulse sonoelastography in patients who have COVID-19 with a healthy control group. This prospective study was conducted between February and July 2021 with 65 cases. We used sonoelastography to evaluate male patients 18 years or older, who had applied to the urology clinic with nontesticular complaints, and were found to not have any underlying testicular pathology after a clinical-laboratory evaluation. The clinical-laboratory imaging findings and reverse transcription-polymerase chain reaction test results of all patients diagnosed with COVID-19 were reviewed from the hospital database. We measured the shear wave velocity values of the epididymis and the testes of 31 proven severe acute respiratory syndrome coronavirus 2 patients and 34 healthy subjects and compared them with an independent t test. For the patient and control group subjects, the mean age was 37.55 ± 13.08 (23-71) and 40.5 ± 16.25 (18-81) years, respectively. The mean shear wave velocity values of the left-right and bilateral testes and epididymis of the patient group were statistically substantially higher ( P ˂ 0.05) than in the control group. In the receiver operating characteristic analysis, when the cutoff values for the bilateral testes and epididymis were determined as 1.39 and 1.64 m/s, respectively, the AUC was 77% to 73.4%, the sensitivity was 87% to 74%, and the specificity was 65% to 62%. Our findings show that testicular and epididymal tissue stiffness increased in patients with COVID-19. We recommend adding sonoelastography to urogenital examinations of male reproductive system in patients who are recovering from COVID-19., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The present study investigates the diagnostic efficiency of apparent diffusion coefficient (ADC) values in differentiating between malignant and benign cavitary lesions on diffusion-weighted magnetic resonance imaging (DWI)., Materials and Methods: This prospective study included 45 consecutive patients identified with a cavitary lung lesion with a wall thickness of ≥5 mm on thoracic computed tomography in our clinic between 2020 and 2022, and who underwent thoracic DWI within 1 week of their original computed tomography. ADC measurements were made on DWI by drawing a region of interest manually from the cavity wall, away from the lung parenchyma in the axial section where the lesion was best demonstrated. The patients were then classified into benign and malignant groups based on the pathology or clinico-radiologic follow-up., Results: The sample included 29 (64.4%) male and 16 (35.6%) female patients, with a mean age of 59.06±17.3 years. Included in the study were 1 patient with 3 and 3 patients with 2 cavitary lesions each, with a total for the sample of 50 cavitary lesions. There were 23 (46%) malignant and 27 (54%) benign cavitary lung lesions. The mean ADC value (×10 -3  mm 2 /s) of the malignant and benign cavitary lesions was 0.977±0.522 (0.511 to 2.872) and 1.383±0.370 (0.930 to 2.213), respectively. The findings were statistically significant using an independent samples t test ( P =0.002). The mean wall thickness of the malignant and benign lesions was 12.47±5.51 mm (5 to 25 mm) and 10.11±4.65 mm (5 to 22 mm), respectively. Although malignant cavities had a higher mean wall thickness than benign cavities, the difference was statistically insignificant ( P =0.104)., Conclusion: A significant difference was identified between the ADC values measured in DWI of the malignant and benign cavitary lung lesions. DWI, a noninvasive and rapid imaging method, can provide useful information for the differential diagnosis of cavitary lesions and can minimize unnecessary biopsies., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: In this study, we aimed to evaluate the computed tomography (CT) findings of Fasciola hepatica infestations on initial and follow-up imagings after treatment, and also to describe the role of CT during diagnosis., Methods: In this retrospective study, patients with a diagnosis of fascioliasis by clinical and laboratory examination who underwent initial and follow-up contrast-enhanced abdominal CT scans after treatment (a single oral dose of 10mg/kg Triclabendazole) were included. The CT scans were evaluated regarding liver and spleen sizes, portal and splenic vein diameters, involved hepatic segment numbers and involvement patterns, the presence of focal perihepatic hyperdensity, gallbladder wall thickening, dilatation of the intrahepatic biliary tract, periportal-right subdiaphragmatic lymphadenopathy, hepatic subcapsular and intra-abdominal bleeding, and perihepatic/intraabdominal free fluid. Initial (pre-treatment) and post-treatment CT scans (average 25 months after the treatment) were compared with for these features., Results: A total of 36 patients with a mean age of 39.28±14.64 [15-83] years, were included in this study. After treatment, marked improvement in liver parenchymal involvement, biliary system findings, hepatomegaly-splenomegaly, periportal-peridiaphragmatic lymphadenopathy, and hepatic subcapsular hematoma were detected and focal perihepatic hyperdensity, free intraperitoneal fluid disappeared., Conclusion: Contrast-enhanced abdominal CT can be used in the diagnosis and post-treatment follow-up of fascioliasis. Awareness of intrahepatic/extrahepatic lesions and all the complications of fascioliasis can greatly aid the diagnosis and also evaluation of the response to treatment., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Purpose: This study aimed to evaluate the diagnosis and determine major and minor criteria of celiac disease (CD) with the malabsorption patterns (MABP) in the small intestine and colon on computed tomography (CT) and additional CT findings., Methods: This retrospective study was conducted with 116 patients diagnosed with CD, 14 CD patients recovering with treatment, and 35 control patients with non-CD. All patients had CT examinations and histopathological diagnoses. The sensitivity, specificity, PPV, NPV, and accuracy values of each CT finding defined in the literature were statistically evaluated. According to the patient and control groups, the numerical values of the findings and the sensitivity and specificity values were measured according to this cut-off value. The distribution of CT findings according to pathological Marsh data was evaluated in CD patients., Results: Sensitivity and specificity were found to be higher in small bowel MABP findings, mesenteric hypervascularity, and increased SMV/aorta diameter. There was a numerically significant difference in MDCT findings between the control and pathological Marsh groups. In the ROC analysis performed in terms of the total numerical values of each MDCT finding observed between the groups, it was found that there were more than 7 MDCT findings, 100% sensitivity, and 92% specificity. The presence of four major and three minor criteria or three major and four minor criteria were considered significant., Conclusions: Being aware of CT findings below the iceberg that may suggest CD in abdominal CT examinations performed in patients with atypical clinical and malabsorption findings or other nonspecific findings may prevent diagnostic delay and unnecessary procedures., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications., Purpose: To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances., Material and Methods: This single-center prospective study was conducted during 2016-2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test., Results: Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5-82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2-7.6 cm) and ADC mean value was 3.03 ± 0.47 (range 2.64-5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8-14 cm) and ADC mean value was 2.99 ± 0.29 (range 2.36-3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs., Conclusion: Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.

Aim: We aimed to evaluate the knowledge levels and attitudes of the students of the Department of Health Management about epilepsy., Method: This descriptive and cross-sectional study was conducted with the voluntary participation of 238 health management department students in their first and third years of study who were registered at the Faculty of Health Sciences summer school exam. We collected the data through a research questionnaire form and the Epilepsy Knowledge and Attitude Scales., Results: Girls accounted for 66.6% (n = 157) all participants, 53.4% of them were 1st year (n = 127), whereas 46.6% (n = 111) were third-year students. Their mean age was 19.97 ± 1.46 years. Among these participants, 52.9% grew in the province (n = 126), 20.6% were smoking, 5% had epilepsy, and 36.6% had relatives with epilepsy. The mean epilepsy knowledge scale score was 5.64 ± 4.41 and the mean epilepsy attitude scale score was 52.55 ± 9.98. The third-year students' epilepsy knowledge score was significantly higher than their first-year counter parts (p < 0.001). We found no statistically significant difference between the first and third-year participants in attitude scores (p = 0.907). A moderate positive correlation was found between the students' knowledge level scores about epilepsy and their total attitude scores (r = 0.405, p < 0.001). The female students had a more positive attitude toward epilepsy and higher scores on the epilepsy knowledge scale than their male counterparts (p = 0.001, p = 0.005, respectively). Students who knew someone with epilepsy had higher epilepsy knowledge and attitude scale scores than those who did not (p = 0.001, p = 0.005 respectively)., Conclusion: The epilepsy knowledge levels and attitude scale scores of health management students were found to be low. Third-year students were found to have higher knowledge levels than first-year students but there was no statistically significant difference between their attitude scores. More education opportunities should be provided for students of the Department of Health Management about this common chronic disease., 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 © 2021 Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to investigate the efficacy of 2-dimensional (2D) shear wave elastography (SWE) in the diagnosis of acute cystitis (AC) in children., Methods: Between June 2019 and March 2020, 126 children with AC and 126 healthy participants were prospectively investigated by 2D SWE and B-mode ultrasound. Elastographic measurements were performed by drawing the contours of the posterior wall of the bladder between the ureter orifices using a free region of interest. The quantitative 2D SWE values of the patients and the healthy group were compared., Results: The mean 2D SWE values of the bladder wall were significantly higher in patients with AC compared to the healthy group (P = .001). On B-mode ultrasound imaging, the bladder wall thickness of patients with AC was higher than that in the healthy group (P = .001). On 2D SWE, when the cutoff value used was 9.25 kPa, the sensitivity, specificity, positive predictive value, and negative predictive value were 92.1%, 88.1%, 89.3%, and 92.6%, respectively, whereas when the cutoff value used was 1.72 m/s, the sensitivity, specificity, positive predictive value, and negative predictive value were 90.5%, 88.9%, 89.1%, and 90.7%. There was a statistically significant positive correlation between the 2D SWE values and wall thickness measurements (P < .001)., Conclusions: Two-dimensional SWE is a noninvasive, fast, and effective imaging method to evaluate the bladder wall in children with AC., (© 2020 American Institute of Ultrasound in Medicine.)

Abstract: It is important to know the age of clot formation to determine an appropriate treatment for deep vein thrombosis (DVT). The present study aims to differentiate between acute and subacute DVT using the shear wave elastography (SWE) technique. Patients with complaints no longer than 4 weeks and who were found to have early-stage (acute-subacute) thrombus on ultrasound (US) between January 2020 and May 2020 were included in the study. All of the patients underwent SWE using a Philips Healthcare EPIQ 5 Ultrasound System Inc. device with a high-resolution linear US probe (eL18-4, 22-2 MHz). Included in the study were 50 patients, including 23 with acute DVT and 27 with subacute DVT. Of the patients, 22 were women and 28 were men, and the mean age was 46.32 ± 11.33 years (range: 24-74 years). The mean SWE value was 2.63± 0.16 (2.39-2.96) in patients with acute DVT and 3.34± 0.31 (2.65-3.88) in patients with subacute DVT. The findings were statistically significant in the comparison of the 2 groups using an independent samples t test (P < 0.001). In the receiver operating characteristic analysis, the area under the curve was found to be 97.6%. When the cutoff value was taken as 2.85 according to the area under the curve, sensitivity was found to be 96.3%, and specificity was 91.3%. Thrombus stage plays a critical role in treatment decisions in DVT in the lower extremities. The present study reveals that the shear wave US elastography technique can be used to discriminate between acute and subacute DVT., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Social isolation and quarantine are unusual precautions taken all over the world against the COVID-19 pandemic. Some legal sanctions were made in order to protect vulnerable age groups such as the geriatric population, to make them stay at home. These measures, which are vital for pandemic management, have negative psychological effects on elderly individuals. The aim of this study was to reveal how pandemic process affected individuals over 65 years old psychosocially., Materials and Methods: Socio-demographic characteristics questionnaire, the COVID-19 Phobia Scale (C19P-S) and the Loneliness Scale for the Elderly individuals were used. Descriptive analysis, Mann-Whitney U-test, Kruskal-Wallis test, Pearson correlation analysis were performed for data analysis., Results: A total of 130 elderly people (80 women, 50 men) were included in the study. Of the participants, 61.5% were women, 67.7% were married and mean age was 71.53 ± 5.57 (min. 65-max. 87) years old. The C19P-S scores were significantly higher in women, singles, people living alone, those living in an apartment, and those with higher economic and educational level (P = .001). There was a strong positive correlation between age and total loneliness score. Loneliness scores were significantly higher in singles, those with higher levels of education and income, those who live alone, who was a relative of a healthcare worker, and whose relatives were infected with COVID-19 (P < .05)., Conclusion: Our study revealed that elderly individuals, who have to comply with social isolation rules, have increased fear and loneliness due to coronavirus. Considering this situation, timely psychological treatment and social support measures should be taken., (© 2021 John Wiley & Sons Ltd.)

Abstract: Hydatid cyst (HC) is a parasitic disease that is endemic particularly to the sheep-breeding regions of the world, our country included. Given their propensity to materialize most commonly in the liver, our study evaluates the value of ultrasound elastography in the differential diagnosis of simple cyst and type I HCs of the liver.The study involved a total of 73 cysts (22 simple cysts, 51 type I HCs) that were removed using the puncture aspiration injection reaspiration technique between 2016 and 2018. All measurements were made using a Siemens ACUSON S2000 (Siemens Healthcare, Erlangen, Germany) device with a 4-MHZ 4C1 convex probe, an acoustic radiation force impulse elastography procedure, and a Virtual Touch IQ option. The difference between the mean shearwave elastography (SWE) values of both groups was analyzed with an independent t test.Of the 70 patients involved in the study, 29 were female and 41 were male, with a mean ± SD age of 38.85 ± 17.62 years (range, 5-82 years). Upon the examination of the 22 simple cysts and the 51 HCs, the mean ± SD SWE values were found to be 2.6 ± 0.96 (0.96-4.25) and 2.8 ± 1.69 (0.66-4.84), respectively. No statistically significant difference was identified between the SWE values of type I HCs and simple cysts (P > 0.005).Although HCs and simple cysts had similar radiological appearances, and a relative difference was noted in the differentiation of the elastographic measurements, this difference was not statistically significant. Accordingly, more comprehensive and various studies are needed., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: This study aims to establish a cut-off value for increases in the esophageal wall thickness measured using computed tomography to differentiate between benign and malignant pathologies., Methods: A total of 144 patients (61 males, 83 females; mean age 57.2±12.4 years; range, 24 to 86 years) who underwent thoracic and/or abdominal computed tomography in the radiology clinic between January 2015 and June 2018 for any reason and who were found to have a thickening of the esophageal wall or gastroesophageal junction were retrospectively analyzed. Tomography images were examined by two radiologists who reached consensus on the wall morphology and thickness, anatomic localization, and any accompanying findings regardless of the endoscopy results. Benign and malignant patients were identified from the endoscopy and/or biopsy results. The receiver operating characteristic analysis was carried out to establish a cut-off value for the lesion wall thickness to differentiate between benign and malignant pathologies and to determine a cut-off value for the lesionlevel thickness-normal segment thickness ratio., Results: A statistically significant difference was found in the wall thicknesses of patients with esophageal cancer and those with benign lesions. According to a cut-off value for wall thickness of 13.5 mm, sensitivity and specificity were found to be 94.3% and 100%, respectively. The lesion-level thickness-normal segment thickness ratio was found to be statistically significant in malignant-benign differentiation, and a significant correlation was found between the asymmetric thickening and malignancy., Conclusion: Increases in the esophageal wall thickness and asymmetry detected on computed tomography can contribute to the early diagnosis of esophageal cancers, particularly in regions endemic to esophageal cancer as in Van province in eastern anatolia region of Turkey. Asymmetric wall thicknesses over 13.5 mm would be highly significant in terms of malignancy in tomographic examinations., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2020, Turkish Society of Cardiovascular Surgery.)

Objective: We aimed to investigate the effect of inhaled corticosteroids (ICS) in the outcomes of community-acquired pneumonia (CAP), as well as to determine if ICS usage is exist among the risk factors for mortality in those patients., Materials and Methods: In this retrospective cross-sectional multicentre study, 1069 hospitalised CAP patients were investigated using CAP Database of Turkish Thoracic Society (TURKCAP Database). The patients were divided into two groups, depending on their ICS use. The data were analysed by appropriate statistical methods., Results: 172 (75.8%) of the 227 patients who were on ICS had COPD and 37 (16.3%) had asthma. There were fewer patients with fever among ICS-users compared to non-ICS users (P = 0.013), and less muscle pain (P = 0.015) and fewer GIS symptoms (P = 0.022). No statistically significant difference was found between ICS use/ type of ICS and the duration of hospitalisation (P = 0.286). The multivariate regression analysis showed that patients using ICS had lower body temperature and, less crackles/bronchial sound. In the multivariate logistic regression model lung cancer (OR: 6.75), glucose (OR: 1.01) and CURB-65 (OR: 1.72) were significantly associated with mortality in the CAP patients. ICS usage were not found to be associated with mortality., Conclusion: The use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalisation duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation., (© 2020 John Wiley & Sons Ltd.)

We aimed to determine histological damage in patients with varicocele by comparing the elasticity of their affected testes with that of their normal contralateral testes as well as normal testes of control subjects without varicocele using shear wave elastography (SWE). In total, 48 patients with varicocele (96 testes) and 52 control subjects (104 testes) were included in this study. Shear wave elastography values were measured in the longitudinal plane using an oval region of interest that covered as much of the testicular contours as possible. Fifty testes with varicocele were classified as group A, 46 normal contralateral testes of the same patients as group B, and 104 normal testes of control subjects as group C. The normal group C testes were randomly chosen from patients who had applied for ultrasonography for any reason and agreed to participate in the study. The testicular volume and SWE values were compared between these 3 groups. The average age of the patients was 28.45 years, and no significant difference in age was found between the 3 groups (P = 0.665). A significant difference in the testicular volume was found between groups A and C (P = 0.014). The SWE values were significantly higher in group A than in groups B and C (P < 0.001). No significant correlation was observed between the testicular volume and SWE values in any of the groups. Our results showed that SWE can be used as an effective technique to assess testicular stiffness in patients with varicocele to predict interstitial fibrosis and the severity of histological damage.

The study aimed to investigate the effectiveness of the vascularization index (VI) obtained using superb microvascular imaging (SMI) technique in the diagnosis of Hashimoto thyroiditis (HT). The thyroid glands of 80 patients with HT and 107 healthy, asymptomatic participants were examined using SMI. The thyroid parenchyma echogenicity was evaluated, and the thyroid gland volume was measured. Vascularization index measurements were performed by manually drawing the contours of the thyroid parenchyma using the free region of interest with color 2-dimensional SMI VI mode. The quantitative VI values of the patients and the asymptomatic group were compared. Correlations between VI values and thyroid autoantibodies and thyroid hormone levels were analyzed. The mean VI value of the thyroid gland was 4.74% ± 1.96% in the asymptomatic group and 12.45% ± 5.87% in HT patients with a statistically significant difference (P < 0.001). Hashimoto thyroiditis can be diagnosed with 86.3% sensitivity and 82.2% specificity when 6.00% VI value was designated as the cutoff value. There was a positive significant correlation between the VI value and the thyroid-stimulating hormone, antithyroglobulin antibodies, anti-thyroid peroxidase antibody levels (P < 0.05); however, no significant correlation was found between the VI values and thyroglobulin and free thyroxine levels (P > 0.05). There was a significant negative correlation between the VI values and the parenchyma echogenicity and positive significant correlation between the thyroid gland volume and the antithyroglobulin antibody and anti-thyroid peroxidase antibody levels (P < 0.05). The VI obtained using the SMI technique can be effectively used as an imaging method for the diagnosis of HT because of its high sensitivity and specificity in representing objective, quantitative numerical values.

The aim of the study was to investigate the efficacy of shear-wave elastography (SWE) in the differentiation of transudative and exudative pleural effusions. This monocentric study comprised 60 cases (17 transudative, 43 exudative).Transthoracic SWE was performed in 60 cases for whom to use thoracentesis for the pleural fluid analysis was planned. The mean SWE values of each patient were recorded, and the correlation between the biochemical analysis results of pleural fluid after thoracentesis and SWE findings was evaluated. The effusion SWE values and biochemical analysis results were compared. Of the 60 patients who participated in this study, 32 (53.4) were male and 28 (46.6%) were female. The mean ± SD age was 59 ± 17.09 years (range = 21-89 years). Simultaneous serum biochemical analysis was performed for the patients with PE. The mean ± SD shear-wave velocity value of the transudative fluid was calculated 2.29 ± 0.41 (1.6-2.94), whereas the mean ± SD shear-wave velocity value of the exudative pleural fluid was calculated as 3.29 ± 0.63 (2.01-4.88) (P < 0.001). The receiver operating characteristic analysis showed that sensitivity and specificity were found as 91% and 76.5%, respectively, when the cutoff value was selected as 2.52 m/s in the differentiation of the transudative and exudative effusions.Shear-wave elastography may help in the differentiation of transudative and exudative of the pleural effusions.

Objective: The aim of this study was to evaluate the reproducibility of measurement of spleen stiffness at the time of the initial detection of splenomegaly, whether it is found incidentally or not, in determining the etiology of splenomegaly., Methods: The pathologies that brought about the diffuse splenomegaly were evaluated in 3 main groups as follows: hepatoportal, myeloproliferative, and infectious causes. In addition, 17 healthy control patients were recruited. All patients were examined with acoustic radiation force impulse imaging with VTQ., Results: The difference between the splenic parenchymal elasticity values in the hepatoportal group (3.27 ± 0.36 m/s), in the myeloproliferative disease group (2.98 ± 0.33 m/s), in the infectious disease group (2.44 ± 0.21 m/s), and in the control group (2.08 ± 0.19 m/s) was found to be statistically significant (P = 0.001). The intraclass correlation coefficient for shear wave velocity measurement between hepatoportal causes and myeloproliferative causes was 71.2% (95% confidence interval [CI], 54.9%-87.4%), between hepatoportal causes and infective causes was 99.7% (95% CI, 98.6%-100.0%), and between myeloproliferative causes and infective causes was 83.3% (95% CI, 68.8%-97.9%). In the same patient groups, spleen volumes were measured as 64.08 ± 9.66, 78.18 ± 18.52, and 51.57 ± 7.44 cm, respectively; in the control group, it was 26.75 ± 6.57 cm. The difference between spleen volumes was found to be statistically significant (P = 0.001)., Conclusions: Distinguishing the causes of splenomegaly is important because the disorders require different management strategies. In diseases that cause splenomegaly, tissue content may change according to pathogenesis. Such changes in the spleen are mechanical properties that can be quantified by elastography.

In this study, the effectiveness of transthoracic ultrasound elastography in the benign and malign distinction of subpleural/pleural solid lesions was investigated.Between July 2015 and December 2016, 33 consecutive patients with subpleural solid lesions detected via computed tomography (CT) of the thorax were identified and prospectively included in this study. The average for each lesion's shear wave velocity (SWV) value was detected, and benign and malignant lesions' SWV values are statistically compared. The CT and pathology results were used as a reference to compare these values. A receiver operating characteristic analysis was used to determine the cutoff value for benign/malignant neoplasms.The 33 patients (10 female, 23 male) included in the study had a mean age of 56.2 ± 15.40 years (range, 17-84 years), and the mean SWV value of the lesions in 13 (39%) cases evaluated benign after a CT scan, histopathological examination, or both 2.18 ± 0.49 m/s. The mean SWV value of the lesions which were histopathologically diagnosed as malign in 23 (61%) cases was 3.50 ± 0.69 m/s. (P < 0.001). When the cutoff value was set as 2.47 m/s for the SVW value, sensitivity and specificity were determined to be 97.7%.The present study has shown that transthoracic ultrasound shear wave elastography can be an effective radiological examination method in the benign and malign differentiation of subpleural lesions and has the potential for use in the routine clinical application of transthoracic ultrasound elastography, a noninvasive method for evaluating the malignancy potentials of such lesions.

Objectives: This study aims to compare the risk of immediate respiratory distress (IRD) during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries., Patients and Methods: A total of 300 patients (180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years) were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1) patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2) patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention., Results: The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females., Conclusion: Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.

Mental health problems and parental anxiety in children with epilepsy were investigated. Parents of 83 children with epilepsy and 172 healthy children were asked to complete Strengths and Difficulties Questionnaire for their children and State-Trait Anxiety Inventory for themselves. In those with epilepsy, 39.8% (n: 33) were girls, 60.2% (n: 50) were boys and their mean age was 9.34 ± 3.99 years. Control group was more successful in school (p < 0.001). Emotional problems score in children with epilepsy was higher than control group (p < 0.001). Case group's behavior problems and attention deficit hyperactivity scores were higher (p < 0.001, p=0.009 respectively). Prosocial behavior scores of the control group were significantly higher (p=0.004). State (p=0.001) and trait (p=0.001) anxiety levels of parents of children with epilepsy were higher. Children with epilepsy have more neuro-behavioral problems; and their parents have greater anxiety levels. Physicians should be in contact with children with epilepsy for the psychological health of the family besides seizure control.

Single bounce attenuated total reflectance (SB-ATR) Fourier transform infrared (FTIR) spectroscopy in conjunction with chemometrics was used for accurate determination of free fatty acid (FFA), peroxide value (PV), iodine value (IV), conjugated diene (CD) and conjugated triene (CT) of cottonseed oil (CSO) during potato chips frying. Partial least square (PLS), stepwise multiple linear regression (SMLR), principal component regression (PCR) and simple Beer׳s law (SBL) were applied to develop the calibrations for simultaneous evaluation of five stated parameters of cottonseed oil (CSO) during frying of French frozen potato chips at 170°C. Good regression coefficients (R(2)) were achieved for FFA, PV, IV, CD and CT with value of >0.992 by PLS, SMLR, PCR, and SBL. Root mean square error of prediction (RMSEP) was found to be less than 1.95% for all determinations. Result of the study indicated that SB-ATR FTIR in combination with multivariate chemometrics could be used for accurate and simultaneous determination of different parameters during the frying process without using any toxic organic solvent., (Copyright © 2014 Elsevier B.V. All rights reserved.)

A series of alkyl phosphates with alkyl chain lengths ranging from C10 to C18 have been synthesized. Self-assembled monolayers (SAMs) of these molecules were prepared on titanium oxide surfaces by immersion of the substrates in alkyl phosphate solutions of 0.5 mM concentration in n-heptane/isopropanol. The SAMs were characterized by means of dynamic water contact angle (dCA) measurements, variable-angle spectroscopic ellipsometry (VASE), X-ray photoelectron spectroscopy (XPS), and polarization-modulated infrared reflection-absorption spectroscopy (PM-IRRAS). A higher degree of order and packing density within the monolayers was found for alkyl phosphates with alkyl chain lengths exceeding 15 carbon atoms. This is reflected in a lower dCA hysteresis, as well as a film thickness measured by VASE and XPS close to the expected values for SAMs with an average alkyl chain tilt angle of 30 degrees to the surface normal. Additionally a shift of the symmetric and antisymmetric C-H stretching modes in the PM-IRRAS spectra to lower wave numbers was observed. These findings imply a higher two-dimensional crystallinity of the films derived from alkyl phosphates with a longer alkyl chain length.