Prognostic role of optic nerve sheath diameter in stroke in emergency department, A case control study

Background

Sonographic measurement of optic nerve sheath diameter (ONSD) can reflect intracranial pressure (ICP) indirectly and determine the neurology intensive care unit (NICU) requirement and mortality in acute ischemic stroke (AIS).

Aim

To demonstrate the effectiveness of ONSD to determine mortality, morbidity, and NICU requirement on patients with the AIS.

Methods

The sonographic ONSD measurements were performed on each patient with AIS, over 18 years old. All patients were categorized according to the Oxfordshire Community Stroke Project (OCSP) classification system. MRI images were examined for increased ICP, and the patients were categorized into two groups as increased ICP (i-ICP) and normal ICP. The ONSD results were evaluated in terms of classifications, outcomes, and prognosis of the patients.

Results

One hundred and five patients were included and 31 (35.2%) were in the i-ICP group. The median ONSDs were 5.26 mm in the i-ICP group and 4.62 mm in the normal ICP group (P < 0.001). The median ONSDs were 5.13 mm in the NICU group and 4.69 mm in the neurology ward (NW) group (P = 0.001). The total anterior circulation infarction (TACI) subgroup had higher ONSDs than the others (TACI: 5.27 mm; PACI: 4.73 mm; POCI: 4.77 mm; and LACI: 4.64 mm, P < 0.001). The NICU requirements were higher in the TACI subgroup. The median ONSD was 5.42 mm in the deceased group (survived: 4.77 mm, P < 0.001).

Conclusion

ONSD may be favorable for predicting the increased ICP and the NICU requirement in OCSP subgroups. Moreover, ONSD can be used to foresee the mortality of AIS.

Evaluation of parenchymal vascularity of the thyroid gland with vascularization index by color superb microvascular imaging in patients with Graves' disease

Aim of the study

To determine the parenchymal vascularity of the thyroid gland with color superb microvascular imaging in patients with Graves’ disease, and compare the vascularization index values with healthy subjects.

Materials and methods

The thyroid glands of 37 patients whose laboratory and clinical findings were consistent with Graves’ disease, and 40 asymptomatic subjects with normal laboratory values, were examined using color superb microvascular imaging. Measurements of the vascularization index were performed with a free region of interest which was drawn along the outer margin of the gland on the color superb microvascular imaging mode. The vascularization index values obtained in the Graves’ disease and control groups were compared. A correlation analysis was performed between the vascularization index values and laboratory and grayscale US parameters.

Results

The median vascularization index value of the thyroid parenchyma in patients with Graves’ disease was significantly higher than in the asymptomatic group [median (min–max); 12 (2.3–32.1) vs 5.04 (1.1–10.8), p <0.001]. When the cutoff value of the vascularization index is determined as 6.3, Graves’ disease can be diagnosed with 83.8% sensitivity and 70% specificity.

Conclusions

The vascularization index obtained with color superb microvascular imaging can be a quantitative indicator of parenchymal vascularity in the diagnosis of Graves’ disease, and serve as a supportive tool.

Common coeliacomesenteric trunk: a computed tomography radiological study

BACKGROUND

There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Coeliacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT).

MATERIALS AND METHODS

A total of 1000 CT angiography images were analysed retrospectively, and the patients with mesenteric and coeliac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients.

RESULTS

Ten patients (6 males and 4 females) with a mean age of 50.2 years (17-87 years) had CMT in CT images.

CONCLUSIONS

The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.

High prevalence of chronic hepatitis D virus infection in Eastern Turkey: urbanization of the disease

INTRODUCTION

Both hepatitis B virus (HBV) and hepatitis D virus (HDV) infection play an increasingly important role in liver diseases. The main objective of this study was to investigate the socio-epidemiological, laboratory and radiological aspects of both HBV and HDV infection near the Iranian border of Turkey.

MATERIAL AND METHODS

The study included 3352 patients with HBV and HDV infection. Socioepidemiological, laboratory and radiological aspects of the study subjects were retrospectively examined. Comorbid metabolic diseases were not assessed due to the retrospective design of the study.

RESULTS

Most of the study subjects were HBe antigen negative. No significant difference in terms of HBV-DNA levels or HBe antigen seropositivity was detected between the city centre and rural areas (p > 0.005). The mean HBV-DNA level in the anti-HDV-positive group was significantly lower than in the anti-HDV-negative group (p < 0.001). The rate of HDV-RNA positivity in women was higher than in their male counterparts (p = 0.017). Anti-HDV-IgG was detected in 18.4% of tested subjects who came from an urban area. In contrast, 12.5% of subjects of the rural group had a positive result for anti-HDV-IgG. Among 134 ultrasonographically evaluated delta hepatitis patients, 37.3% had liver cirrhosis. On the other hand, in 1244 patients with hepatitis B monoinfection, there were 90 patients with liver cirrhosis. Radiologically, the rate of hepatic steatosis in delta hepatitis patients was lower than in those with HBV monoinfection.

CONCLUSIONS

Hepatitis D virus infection was particularly prevalent among the urban population as well as in female subjects. More broadly, the current observations are the first to suggest an inverse correlation between delta hepatitis and ultrasonography-proven hepatic steatosis.