Exploring the quadriceps muscle architecture variations in various sports disciplines: a comparative analysis of football, taekwondo, and athletics

BACKGROUND

The purpose of this study was to comprehensively investigate and compare the architecture of the quadriceps muscle in football, taekwondo, and athletics, shedding light on potential differences and providing valuable insights for athletic training and performance enhancement.

METHODS

Thirty-five athletes (football[N.]=14. [7 women, 7 men]; taekwondo [N.]=11. [6 women, 5 men]; athletics [N.]=10. [5 women, 5 men]) aged 17-21 years participated in the study. After participant demographic data were collected, 2D real-time B-mode ultrasound (USG) and right (R) and left (L) leg quadriceps muscle group rectus femoris (RF), vastus intermedius (VI), vastus lateralis, pennation angle (PA), RF cross-sectional area (CSA), and subcutaneous fat thickness were determined.

RESULTS

In the study, in female athletes, R-RF+VI (P=0.04, ES:4.34), R-VI (P=0.01, ES: 6.1), R-RF: (P=0.009, ES: 7.9), R-CSA (P=0.04, ES: 5.2), L-RF (P=0.002, ES: 10.4) and L-CSA (P=0.007, ES: 7.7) significant differences were found in favor of the Football group. In male athletes, R-CSA (P=0.004, ES: 9.05), L-RF (P=0.05, ES: 3.5) and L-SFT (P=0.00, ES: 13.6), there was a significant difference in favor of the Football group. L-PA (P=0.009, ES: 6.2). L-PA (P=0.009, ES: 6.2) was significantly higher in the male Taekwondo group.

CONCLUSIONS

Our research findings show that there is a significant relationship between the type of exercise performed and the structural differences observed in the quadriceps muscle. Consequently, it is highly recommended to consider the outcomes of our study for enhancing the efficacy of training programs in the domains of football, taekwondo, and athletics.

Effect of vaccination status on CORADS and computed tomography severity score in hospitalized COVID-19 patients: A retrospective study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic is continuing. The disease most commonly affects the lungs. Since the beginning of the pandemic thorax computed tomography (CT) has been an indispensable imaging method for diagnosis and follow-up. The disease is tried to be controlled with vaccines. Vaccination reduces the possibility of a severe course of the disease.

AIM

The aim of this study is to investigate whether the vaccination status of patients hospitalized due to COVID-19 has an effect on the CT severity score (CT-SS) and CORADS score obtained during hospitalization.

METHODS

The files of patients hospitalized between April 1, 2021 and April 1, 2022 due to COVID-19 were retrospectively reviewed. A total of 224 patients who were older than 18 years of age, whose vaccination status was accessible, whose severe acute respiratory syndrome coronavirus 2 polymerase chain reaction result was positive, and who had a Thorax CT scan during hospitalization were included in the study.

RESULTS

Among the patients included in the study, 52.2% were female and the mean age was 61.85 years. The patients applied to the hospital on the average 7th day of their complaints. While 63 patients were unvaccinated (Group 1), 20 were vaccinated with a single dose of CoronaVac (Group 2), 24 with a single dose of BioNTech (Group 3), 38 with 2 doses of CoronaVac (Group 4), 40 with 2 doses of BioNTech (Group 5), and 39 with 3 doses of vaccine (2 doses of CoronaVac followed by a single dose of BioNTech, Group 6). CT-SS ranged from 5 to 23, with a mean of 12.17.CT-SS mean of the groups were determined as 14.17, 13.35, 11.58, 10.87, 11.28, 10.85, respectively. Accordingly, as a result of the comparisons between the groups, the CT-SS levels of the unvaccinated patients found to be significantly higher than the other groups. As the vaccination rates increased, the rate of typical COVID-19 findings on CT was found to be significantly lower.

CONCLUSION

Increased vaccination rates in COVID-19 patients reduce the probability of typical COVID-19 symptoms in the lungs. It also reduces the risk of severe disease and decreases CT Severity Scores. This may lead to a loss of importance of Thorax CT in the diagnosis of COVID-19 pneumonia as the end of the pandemic approaches.

Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter study

PURPOSE

To evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta.

METHODS

This study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded.

RESULTS

Ischemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations.

CONCLUSION

Abdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.

Chronic otitis media and middle ear variants: Is there relation?

BACKGROUND

Chronic otitis media (COM) is an inflammatory disease that lasts for a long time. It is common in developing countries. Hearing loss can result from COM. The relationship between variations in middle ear anatomy and COM was investigated in our study.

AIM

To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals.

METHODS

This retrospective study included 500 patients with COM and 500 healthy controls. The presence of those variants was determined: Koerner’s septum, facial canal dehiscence, high jugular bulb, jugular bulb dehiscence, jugular bulb diverticulum, sigmoid sinus anterior location and deep tympanic recesses.

RESULTS

A total of 1000 temporal bones were examined. The incidences of these variants were respectively (15.4%-18.6%), (38.6%-41.2%), (18.2%-4.6%), (2.6%-1.2%), (1.2%-0%), (8.6%-0%), (0%-0%). It was observed that only high jugular bulb (P < 0.001) and anteriorly located sigmoid sinus frequencies (P = 0.002) in the case group were statistically significantly higher than the control groups.

CONCLUSION

COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease. We didn't find a positive correlation between COM and Koerner’s septum and facial canal defect. We ended up with a significant conclusion with the variants of dural venous sinuses -high jugular bulb, dehiscence of jugular bulb, diverticulum of jugular bulb and anteriorly located sigmoid sinus- that have been studied less and frequently associated with inner ear illnesses.

Are paraspinal muscle quantity, lumbar indentation value, and subcutaneous fat thickness related to disc degeneration? An MRI-based study

INTRODUCTION

The aim of the study was to investigate the relationship between lumbar disc herniation and Goutallier classification (GC), lumbar indentation value, and subcutaneous adipose tissue thickness.

METHODS

102 consecutive patients (59 female and 43 male) with lumbar back pain, numbness, tingling, or pain in the lower extremity indicating radiculopathy who had undergone lumbar magnetic resonance imaging (MRI) and had an intervertebral disc herniation in the L4-5 level, were included in the study. 102 patients who have undergone lumbar MRI in the same time period and have no disc herniation were chosen to be the control group and were selected so as to match the herniated group for sex and age. All these patients' scans were re-interpreted regarding paraspinal muscle atrophy (using the GC), lumbar indentation value, and subcutaneous adipose tissue thickness in the L4-5 level.

RESULTS

The Goutallier score was higher in the herniated group, compared with the non-herniated group (p < 0.001). There was no statistical difference between herniated and non-herniated groups regarding lumbar indentation value (LIV) and subcutaneous adipose tissue thickness (SATT). A Goutallier score of 1.5 provided the highest sensitivity x specificity value to indicate the disc herniation according to the statistical results. The individuals with a Goutallier score of 2, 3, and 4 have 2.87 times more likely to have disc herniation in their MRIs than the ones with a score of 0 and 1.

CONCLUSION

Paraspinal muscle atrophy seems to be related to the presence of disc herniations. The cut-off value of GC to indicate the disc herniation in this study might be useful to predict the risk for disc herniation regarding the Goutallier score. The LIV and SATT measured in magnetic resonance images were randomly distributed between individuals with herniated and non-herniated groups, and statistically, no relationship was observed between these groups regarding these parameters.

IMPLICATIONS FOR PRACTICE

The effect of the parameters studied in this research on disc herniations are expected to be an added value to the literature. The awareness of risk factors for intervertebral disc herniations might be used in preventive medicine to predict the risk and understand the tendency of an individual for disc herniations to occur in the future. Further investigations are needed to establish whether there is a causal relationship or correlation between these parameters and disc herniation.

COVID-19-related cardiomyopathy: Can dual-energy computed tomography be a diagnostic tool?

BACKGROUND

No study on dual energy computed tomography (DECT) has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019 (COVID-19) patients. Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion, and these deficits can be shown via DECT with a perfect interrater agreement.

AIM

To assess lung perfusion alterations in COVID-19 patients. To our knowledge, no study using DECT has been performed to evaluate possibly fatal cardiac/ myocardial problems in COVID-19 patients. The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.

METHODS

Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association’s classification of the segmentation of the left ventricular myocardium. Additionally, intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated. Following segment-by-segment analysis, perfusion deficiencies identified on the iodine map pictures on DECT were identified.

RESULTS

The study enrolled a total of 87 patients. Forty-two of these individuals were classified as COVID-19 positive, and 45 were classified as controls. Perfusion deficits were identified in 66.6% (n = 30) of the cases. All control patients had a normal iodine distribution map. Perfusion deficits were found on DECT iodine map images with subepicardial (n = 12, 40%), intramyocardial (n = 8, 26.6%), or transmural (n = 10, 33.3%) anatomical locations within the left ventricular wall. There was no subendocardial involvement in any of the patients.

CONCLUSION

Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion. These deficits can be shown via DECT with a perfect interrater agreement. Additionally, the presence of perfusion deficit is positively correlated with D-dimer levels.

Long-term lung perfusion changes related to COVID-19: a dual energy computed tomography study

PURPOSE

Although the findings of acute new coronavirus disease (COVID-19) infection on dual-energy computed tomography (DECT) have recently been defined, the long-term changes in lung perfusion associated with COVID-19 pneumonia have not yet been clarified. We aimed to examine the longterm course of lung perfusion in COVID-19 pneumonia cases using DECT and to compare changes in lung perfusion to clinical and laboratory findings.

METHODS

On initial and follow-up DECT scans, the presence and extent of perfusion deficit (PD) and parenchymal changes were assessed. The associations between PD presence and laboratory parameters, initial DECT severity score, and symptoms were evaluated.

RESULTS

The study population included 18 females and 26 males with an average age of 61.32 ± 11.3 years. Follow-up DECT examinations were performed after the mean of 83.12 ± 7.1 (80-94 days) days. PDs were detected on the follow-up DECT scans of 16 (36.3%) patients. These 16 patients also had ground-glass parenchymal lesions on the follow-up DECT scans. Patients with persistent lung PDs had significantly higher mean initial D-dimer, fibrinogen, and C-reactive protein values than patients without PDs. Patients with persistent PDs also had significantly higher rates of persistent symptoms.

CONCLUSION

Ground-glass opacities and lung PDs associated with COVID-19 pneumonia can persist for up to 80-90 days. Dual-energy computed tomography can be used to reveal long-term parenchymal and perfusion changes. Persistent PDs are commonly seen together with persistent COVID-19 symptoms.

Can forensic radiological skeletal age estimation be performed by examining ischiopubic-ilioischial-iliopubic synchondrosis in computed tomography images?

Introduction

In this study, we evaluated whether it is possible to perform forensic radiological skeletal age estimation via radiological examination of the ilioischial, ischiopubic, and iliopubic synchondrosis regions of the pelvis.

Methods

This study was conducted by retrospectively examining the abdominopelvic images of individuals aged 8–16 who had applied to the hospital for any reason without having a chronic disorder and who had undergone computed tomography. Two radiologists retrospectively reviewed the images. The BT images of the pelvis ilioischial, ischiopubic, and iliopubic synchondrosis regions were evaluated as follows: 0: open, 1: semiclosed, and 2: closed. The data were evaluated using the SPSS 17 program.

Results

Two hundred sixty-three children (118 girls and 145 boys) between the ages of 8 and 16 years without any health problems participated. There was a significant difference between the groups for all the evaluated synchondrosis joints in girls and boys (p<0.001 for each group comparison). We observed that ilioischial, ischiopubic, and iliopubic synchondrosis closed earlier in girls than boys. In addition, we found that the joints were closed at the age of 15 and over in boys and at 14 and over in girls.

Discussion

Some studies have previously evaluated synchondrosis by using computed tomography. We showed that forensic radiological skeletal age estimation could be performed by examining ischiopubic-ilioischial-iliopubic synchondrosis in pelvis computed tomography images. The pelvis is more resistant to decay than other parts of the body. Furthermore, pelvis bones can withst and the effects of postmortem animal attacks for a longer period. Therefore, we believe that forensic age estimation can be made on corpses with no extremity, a damaged chest, or whose only pelvic bones are assessable through the method we use.

Conclusion

In our study, the ischiopubic-ilioischial-iliopubic joints were open in those aged nine and under and closed in those aged 15 and above. Ilioischial, ischiopubic, and iliopubic synchondrosis were observed to close earlier in girls than in boys. We consider that our study will be beneficial in the 8-16-year-old age group if used. In addition, our study can be used to determine the radiological bone age in cases with wrist bone abnormalities or wrist amputation.

Acute mesenteric lymphadenitis in children: findings related to differential diagnosis and hospitalization

INTRODUCTION

Diagnostic discrimination between acute appendicitis (AA) and mesenteric lymphadenitis (AML) may require more diagnostic tests or great skill after excluding other diagnoses. This study aimed to make a differential diagnosis between AA and AML patients with previous and new parameters and to examine which parameters should be taken into account regarding whether the AML patient should be hospitalized or discharged.

MATERIAL AND METHODS

One hundred and twenty-three AML and 134 AA patients, randomly selected, were included in the study. Demographic, clinical, and laboratory data of all subjects were analyzed. Ultrasonographic and rarely computed tomography examinations evaluating for the enlarged lymph nodes with the shortest diameter in the right lower quadrant of the AML patients were performed. Also, the erect abdominal radiographs (EAR) of AML and AA patients were evaluated.

RESULTS

While there was no statistically significant difference in age or gender, C-reactive protein, white blood cell count, monocyte percentage as well as symptoms between the AA and AML groups (p > 0.05), neutrophil and lymphocyte percentage, appearance of EAR and L/M ratio were significantly different between the two groups (p < 0.05). There was no correlation between the short-axis diameter of the mesenteric lymph node and clinical and laboratory findings in the AML group (p > 0.05).

CONCLUSIONS

Based on the results with ROC curve analysis, we propose to take into account the L/M ratio and the EAR from the parameters in the differential diagnosis between AA and AML in addition to previously reported parameters. Also, we recommend that the same features may be used to decide whether AML patients under observation are hospitalized or not.

Evaluation of Portal Vein Doppler Findings in Patients with Crimean⁻Congo Hemorrhagic Fever

Background and objectives: In this study, we compare portal vein Doppler ultrasound (US) findings between patients with Crimean-Congo hemorrhagic fever (CCHF) and healthy persons and investigate the practicability of these findings in the prediction of disease severity. Materials and Methods: In this prospective study, portal vein Doppler US was performed in patients diagnosed with CCHF and healthy persons between March 2016 and May 2018. The patients were grouped according to mild-to-moderate and severe progression of CCHF. Liver size, portal vein diameter, portal vein flow rate, spleen volume, and splenic vein diameter were recorded in the patients and healthy controls. Results: Of the 48 patients diagnosed with CCHF, 25 were male. According to the scoring made, 38 patients were evaluated as having mild-to-moderate disease progression, and 10 were evaluated as having severe disease progression. With respect to the Doppler US findings, liver size, spleen volume, portal vein diameter, splenic vein diameter, and portal vein flow rate were significantly higher in the patient group compared with the controls. However, no significant difference was found in these parameters between the severe and mild-to-moderate progression groups. Conclusions: In the evaluation of and follow-up with patients with CCHF, portal vein Doppler US is a non-invasive and reliable tool for diagnosis.

Effect of Prone and Supine Positioning on Computed Tomography Urography Examination

OBJECTIVES

The aim of this study is to evaluate the effects of performing computed tomography (CT) urogram in the prone position in terms of diagnosis.

METHODS

CT urograms of 208 patients imaged randomly in the prone and supine positions were included in this study. A total of 199 patients and 370 collecting systems were examined in total. Axial raw data and reconstructed coronal thin and thick MIP images with a slice thickness of 5 mm were evaluated by 2 independent radiologists blinded to the initial diagnosis. Renal collecting system, ureters, and bladder were included in radiological evaluation. Anatomically, the renal collecting system was separated into 7 regions. Filling and dilatation of collecting systems were evaluated via images at urogram phase by scoring.

RESULTS

Filling in lower pole infundibulum (p = 0.006), distal ureter (p = 0.006); and highly dilated lower pole calyx (p = 0.020), pelvis (p = 0.006), and bladder (p < 0.001) were determined to be better in images in the prone position compared to the supine position. There were no statistical differences in other regions.

CONCLUSION

Better contrast material filling is achieved in dilated or non-dilated lower pole collecting system, dilated renal pelvis, non-dilated distal ureter of kidney, and in the bladder only by imaging the urogram phase in the prone position compared to the supine position. Additionally, presence of dilatation is a factor that could adversely affect filling. Studies in the future may investigate the contribution of prone positioning to CT urogram with larger series comparing it with other methods and modalities.

[A case of brucellosis presenting with suppurative parotitis involvement]

Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.