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This cross-sectional study was carried out to examine the association between osteoporosis and specific risk factors among 384 women referred to the Radiology Department at King Abdullah University Hospital, Irbid, Jordan during the period September 2009-August 2010 for diagnosis of osteopenia or osteoporosis. Bone mineral density measurements were carried out using dual energy X-ray absorptiometry at both the lumbar spine [AP: L1-L4] and femoral hip (neck, trochanter). Studied risk factors included age, age at menarche, menopause, body mass index, diabetes mellitus, hypertension, renal problems and smoking. The prevalence of osteoporosis among the studied sample was 13.5%. Osteoporosis was significantly associated with current age, age at menarche, diabetes mellitus, hypertension, and renal problems. [ABSTRACT FROM AUTHOR]

Objective. To assess the findings and usefulness of hysterosalpingography (HSG) as a routine investigation in the fertility workup prior to selective laparoscopy. Design. Descriptive retrospective study. Setting. A university hospital in the north of Jordan. Subjects. All patients who underwent hysterosalpingography in the period 1 January - 31 December 2008. Outcome measures. Detection of uterine and fallopian tube abnormalities and their correlation with laparoscopic findings. Results. During the study period, 281 infertile women underwent HSG with no post-procedural complications. The mean (SD) age was 31.5 (5.9) years. Mean (SD) duration of infertility was 4 (3.4) years. Infertility was reported as primary and secondary in 119 (42.3%) and 162 (57.6%), respectively. Altogether, 281 patients and 562 tubes were examined. Of those, 402 were patent and 160 occluded. In only one woman were peritubal adhesions diagnosed. Because of hysterosalpingographically diagnosed tubal occlusion, 46 women (16.4%) were referred for laparoscopy. Eight (17.3%) of them were treated with unilateral salpingectomy, and 28 (60.8%) with bilateral salpingectomy. Salpingolysis was performed on 7 (15.2%) women; 3 (6.7%) women had untreatable adhesions. The concordance was 71.7%. The sensitivity of HSG was 80%, the specificity 50%, the negative predictive value 61%, and the positive predictive value 71%. Of the total of 281 women, 30 (10.7%) conceived within 1 - 11 months after HSG. Conclusion. The very high abnormal predictive value of HSG in the diagnosis of tubal occlusion suggests that this procedure could be performed as a screening examination. [ABSTRACT FROM AUTHOR]

Abstract Background Iron-sulfur [Fe-S] clusters are prosthetic groups required to sustain fundamental life processes including electron transfer, metabolic reactions, sensing, signaling, gene regulation and stabilization of protein structures. In plants, the biogenesis of Fe-S protein is compartmentalized and adapted to specific needs of the cell. Many environmental factors affect plant development and limit productivity and geographical distribution. The impact of these limiting factors is particularly relevant for major crops, such as soybean, which has worldwide economic importance. Results Here we analyze the transcriptional profile of the soybean cysteine desulfurases NFS1, NFS2 and ISD11 genes, involved in the biogenesis of [Fe-S] clusters, by quantitative RT-PCR. NFS1, ISD11 and NFS2 encoding two mitochondrial and one plastid located proteins, respectively, are duplicated and showed distinct transcript levels considering tissue and stress response. NFS1 and ISD11 are highly expressed in roots, whereas NFS2 showed no differential expression in tissues. Cold-treated plants showed a decrease in NFS2 and ISD11 transcript levels in roots, and an increased expression of NFS1 and ISD11 genes in leaves. Plants treated with salicylic acid exhibited increased NFS1 transcript levels in roots but lower levels in leaves. In silico analysis of promoter regions indicated the presence of different cis-elements in cysteine desulfurase genes, in good agreement with differential expression of each locus. Our data also showed that increasing of transcript levels of mitochondrial genes, NFS1/ISD11, are associated with higher activities of aldehyde oxidase and xanthine dehydrogenase, two cytosolic Fe-S proteins. Conclusions Our results suggest a relationship between gene expression pattern, biochemical effects, and transcription factor binding sites in promoter regions of cysteine desulfurase genes. Moreover, data show proportionality between NFS1 and ISD11 genes expression.

Aims: To assess the diagnostic performance of digital breast tomosynthesis (DBT) in older women across varying breast densities and to compare its effectiveness for cancer detection with 2D mammography and ultrasound (U/S) for different breast density categories. Furthermore, our study aimed to predict the potential reduction in unnecessary additional examinations among older women due to DBT., Methods: This study encompassed a cohort of 224 older women. Each participant underwent both 2D mammography and digital breast tomosynthesis examinations. Supplementary views were conducted when necessary, including spot compression and magnification, ultrasound, and recommended biopsies. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated for 2D mammography, DBT, and ultrasound. The impact of DBT on diminishing the need for supplementary imaging procedures was predicted through binary logistic regression., Results: In dense breast tissue, DBT exhibited notably heightened sensitivity and NPV for lesion detection compared to non-dense breasts (61.9% vs. 49.3%, p < 0.001) and (72.9% vs. 67.9%, p < 0.001), respectively. However, the AUC value of DBT in dense breasts was lower compared with non-dense breasts (0.425 vs. 0.670). Regarding the ability to detect calcifications, DBT demonstrated significantly improved sensitivity and NPV in dense breasts compared to non-dense breasts (100% vs. 99.2%, p < 0.001) and (100% vs. 94.7%, p < 0.001), respectively. On the other hand, the AUC value of DBT was slightly lower in dense breasts compared with non-dense (0.682 vs. 0.711). Regarding lesion detection for all cases between imaging examinations, the highest sensitivity was observed in 2D mammography (91.7%, p < 0.001), followed by DBT (83.7%, p < 0.001), and then ultrasound (60.6%, p < 0.001). In dense breasts, sensitivity for lesion detection was highest in 2D mammography (92.9%, p < 0.001), followed by ultrasound (76.2%, p < 0.001), and the last one was DBT. In non-dense breasts, sensitivities were 91% ( p < 0.001) for 2D mammography, 50.7% ( p < 0.001) for ultrasound, and 49.3% ( p < 0.001) for DBT. In terms of calcification detection, DBT displayed significantly superior sensitivity compared to 2D mammography in both dense and non-dense breasts (100% vs. 91.4%, p < 0.001) and (99.2% vs. 78.5%, p < 0.001), respectively. However, the logistic regression model did not identify any statistically significant relationship ( p > 0.05) between DBT and the four dependent variables., Conclusion: Our findings indicate that among older women, DBT does not significantly decrease the requirement for further medical examinations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gharaibeh, Alfwares, Elobeid, Khasawneh, Rousan, El-Heis, Al-Jarrah, Haj Hussein, Altalhi and Abualigah.)

There has been a recent outbreak of monkeypox in the United States, mostly among men who have sex with men (MSM). It seems to be a self-limiting disease but can be potentially serious in immunocompromised patients. Monkeypox infection is transmitted mainly through skin-to-skin contact and possibly seminal and vaginal fluids. Very few cases of monkeypox infection in immunocompromised patients have been published in the literature. We report a case of infection in a renal transplant recipient, and describe the clinical course and outcome., Learning Points: There has been a recent outbreak of monkeypox infection in the United States and more studies are needed to assess the disease course in different patient populations.Monkeypox infection seems to have a similar clinical course in renal transplant recipients as in the general population.There is a higher risk of transmission among renal transplant recipients in men who have sex with men., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2023.)

Kidney tumor (KT) is one of the diseases that have affected our society and is the seventh most common tumor in both men and women worldwide. The early detection of KT has significant benefits in reducing death rates, producing preventive measures that reduce effects, and overcoming the tumor. Compared to the tedious and time-consuming traditional diagnosis, automatic detection algorithms of deep learning (DL) can save diagnosis time, improve test accuracy, reduce costs, and reduce the radiologist's workload. In this paper, we present detection models for diagnosing the presence of KTs in computed tomography (CT) scans. Toward detecting and classifying KT, we proposed 2D-CNN models; three models are concerning KT detection such as a 2D convolutional neural network with six layers (CNN-6), a ResNet50 with 50 layers, and a VGG16 with 16 layers. The last model is for KT classification as a 2D convolutional neural network with four layers (CNN-4). In addition, a novel dataset from the King Abdullah University Hospital (KAUH) has been collected that consists of 8,400 images of 120 adult patients who have performed CT scans for suspected kidney masses. The dataset was divided into 80% for the training set and 20% for the testing set. The accuracy results for the detection models of 2D CNN-6 and ResNet50 reached 97%, 96%, and 60%, respectively. At the same time, the accuracy results for the classification model of the 2D CNN-4 reached 92%. Our novel models achieved promising results; they enhance the diagnosis of patient conditions with high accuracy, reducing radiologist's workload and providing them with a tool that can automatically assess the condition of the kidneys, reducing the risk of misdiagnosis. Furthermore, increasing the quality of healthcare service and early detection can change the disease's track and preserve the patient's life., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Dalia Alzu'bi et al.)

Purpose: To describe the radiological characteristics for childhood intussusceptions including unusual radiological features and rare pathological lead points (PLP)., Material and Methods: The medical records of all childhood intussusceptions between 1/1/2010 -1/10/2020 were retrospectively reviewed. 95 cases were identified in 82 patients. The demographic data, presenting symptoms, diagnostic and treatment methods, radiological features, and PLPs among the different types of intussusception were analyzed., Results: Ileocolic intussusception (ICI) represented 53.7% (51/95). The average age for ICI was 1.87 years. Males constituted 72.1% (31/43). 29.4% (15/51) were treated primarily surgically due to peritonitis. Small bowel intussusception (SBI) represented 40% (38/95) in which females constituted 51.5% (17/33). Ileo-ileal represented 63.2% (24/38). 81.8% (27/33) were transient. On ultrasound; There was a statistically significant difference in the size of the outer diameter of ICI compared to SBI (P-value 0.00012). Ileo-ileocolic and colo-colic intussusceptions constituted 3.2% (3/95); each and were more common in females. Vomiting was the most common symptom for intussusception and ultrasound was diagnostic in the majority of cases. PLPs were seen in 36.6% (30/82) of the patients of which the average age was 7 years. PLPs/risk factors were benign in 80% (24/30). A case of colo-colic intussusception was seen in a 16-year-old female due to clear cell sarcoma which was not reported before. 12.2% patients (10/82) had recurrent intussusception., Conclusion: Our study showed that ICI is the most commonly encountered type. SBIs are mostly transient. It is important to radiologically determine the type of intussusception and to identify PLPs or unusual radiological features to avoid unnecessary intervention and significant patient morbidity., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s).)

Introduction: Blunt leg trauma is common; however, it is rarely associated with significant vascular injury. This study was undertaken to determine the risk factors attributed to failure of limb salvage in acute postoperative period in blunt leg trauma with vascular injuries after revascularization., Methods: A retrospective analysis was conducted of all patients with blunt leg trauma involving bone and soft tissue associated with vascular injuries. They were studied in terms of demographic data, associated comorbidities, mechanism of trauma, associated extra leg injuries, type and nature of bone fractures, soft-tissue injuries, nerve injuries, time of ischemia, Injury Severity Score (ISS), Mangled Extremity Severity Score (MESS), injured vascular segments, modality of vascular repair, modality of bone fixation, thrombosis at the site of vascular repair, complications, limb salvage failure, and mortality., Results: Vascular injuries were identified in 45 arterial segments and 9 popliteal veins among 31 patients. The patients were 93% male, with a mean age of 31 years. The MESS ranged from 6 to 11, and the ISS ranged from 9 to 41. The main pathology of the injured vessels was contusion/thrombosis in 28 legs, which were repaired by interposition-reversed long saphenous vein graft. Seven patients developed postoperative thrombosis and underwent thrombectomy/embolectomy. Failure of limb salvage occurred in seven limbs with no mortality., Conclusions: Severe multi-segmental bone fractures, prolong ischemic time of >10 h, and MESS of ≥9 are significant predictors of limb loss in patients with blunt leg trauma in association with vascular injuries., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Emergencies, Trauma, and Shock.)

Aims: Increased level of glycated hemoglobin (HbA1c) is associated with an increased prevalence of peripheral arterial disease (PAD). This study aimed to assess the relationship between the anatomical distribution of symptomatic PAD lesions in patients with type 2 diabetes and HbA1c levels at the time of PAD diagnosis., Patients and Methods: A retrospective study was conducted at King Abdullah University Hospital during the period August 2011 to December 2015. Consecutive patients with type 2 diabetes presented with symptomatic PAD confirmed by computed tomography-angiography (CTA) were included in this study. CTA images were reviewed. Relevant information including demographic data, PAD symptoms, comorbidities, HbA1c level, lipid profile, C-reactive protein and the mean platelets volume were retrieved from medical records., Results: A total of 332 patients with type 2 diabetes (255 males and 77 females) were included in this study. The mean HbA1c at the time of PAD diagnosis was 8.68% (±2.06%). The prevalence of hemodynamic relevant atherosclerotic lesions of the superficial femoral artery, popliteal artery, leg vessels, femoro-popliteal, and crural segments was significantly higher in patients with HbA1c >7.5% compared with patients with HbA1c ⩽7.5%., Conclusion: The anatomical distribution of symptomatic PAD in patients with type 2 diabetes mellitus differed significantly according to HbA1c level at the time of PAD diagnosis., Competing Interests: Conflict of interest statement: The authors declare that there is no conflict of interest., (© The Author(s), 2021.)

To assess extraspinal findings (ESFs) prevalence in lumbar spine MRI, including clinically significant findings using a systematic approach, and to determine their reporting rate. Lumbar spine MRI scans were retrospectively reviewed over 18 months by two radiologists. Reading discrepancies were resolved by consensus. ESFs were classified according to the involved system, clinical diagnosis, and clinical significance. The reporting rate was estimated by referring to the original report. There were 1509 ESFs in 1322/4250 patients with a substantial agreement between the two radiologists (kappa = 0.8). Almost half (621/1322) were in the 45-60 age group. Females represented 56.6% (748/1322). 74.2% (1120/1509) of the ESFs involved the urinary system among which 79.6% (892/1120) were renal cysts. Clinically significant findings represented 8.7% (131/1509) among which hydronephrosis represented 23% (30/131). First time detected malignant lesions represented 4.6% (6/131). ESFs reporting rate was 47.3%. 58.8% of the clinically significant ESFs were not reported. ESFs prevalence was 31.1%. The Urinary system was the most commonly involved. Most ESFs were benign warranting no further workup. However, clinically significant ESF were not infrequently detected. More than half of the clinically significant findings were not reported. A systematic review of MRI images is highly recommended to improve patient's outcome.

Background: Femoral pseudoaneurysm is the most important access site complication following cardiac catheterization. Ultrasound-guided compression repair is a safe and effective therapeutic modality with variable failure rates and risk factors. The aim of this study was to investigate which factors were associated with a higher incidence of ultrasound-guided compression repair failure for post-cardiac catheterization femoral pseudoaneurysm., Methods: Data were retrospectively collected from medical records at King Abdullah University Hospital during the period from January 2011 to December 2016. A total of 42 patients with post-cardiac catheterization femoral pseudoaneurysm had attempted ultrasound-guided compression repair. Data regarding patients, procedure and aneurysm-related factors were evaluated by univariate analysis and multivariate logistic regression., Results: Ultrasound-guided compression repair failed in 31% of the patients. Patients with body mass index of ⩾28 kg/m 2 , platelet count of ⩽180,000/L, time lag (age of aneurysm) of >48 h following puncture time, aneurysmal neck diameter of ⩾4 mm and communicating tract length of <8 mm were associated with higher rate of ultrasound-guided compression repair failure in the univariate analysis. In the multivariate analysis, time lag (age of aneurysm) > 48 h (odds ratio = 5.7), body mass index ⩾ 28 kg/m 2 (odds ratio = 7.8), neck diameter > 4 mm (odds ratio = 14.4) and tract length < 8 mm (odds ratio = 18.6) were significantly associated with ultrasound-guided compression repair failure., Conclusion: Ultrasound-guided compression repair for patients with post-cardiac catheterization femoral pseudoaneurysm was successful in 69% of the patients. Risk factors for failed ultrasound-guided compression repair were as follows: delayed ultrasound-guided compression repair of >48 h, body mass index ⩾ 28 kg/m 2 , wide neck diameter > 4 mm and short aneurysmal communication tract < 8 mm., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.