Evaluation of tendoAchilles Lesions by (MRI)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Mohamed Abd Elraouf ◽  
Mennatallah Hatem Shalaby ◽  
Mohamed AbdElaziz Yehia Rabeai
Keyword(s):  
The Body ◽  
Radiology Department ◽  
Full Thickness ◽  
University Hospitals ◽  
Partial Thickness ◽  
Careful Clinical Examination ◽  
Important Diagnostic Tool ◽  
Study Population ◽  
Mri Study

Abstract Background: The AT is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity; despite its strength, the AT is also vulnerable to injury, due to its limited blood supply from musculotendinousa, also it withstands great forces, especially during sporting exercises and it's located superficially. Aim of the Work: To evaluate the role of (MRI) in the diagnosis of AT disorders. Patients and Methods: Type of Study: retrospective and prospective studies. Study Setting The study was conducted in Radiology Department at Ain Shams University Hospitals. Study Period from march 2018 to march 2020. Study Population This study included 40 patients. The patients were referred from either the orthopedic, rheumatology outpatient clinics of Ain Shams hospitals or private clinics to radiology department in Ain Shams University. Results Full thickness tear (30.0%) and Tendenosis (30.0%) were the most frequently detected pathologies followed by partial thickness tear (27.5%) and bursitis ( 22.5%) with significant more risk in male gender and middle age ( >46 years). More than one pathology were found in the same MRI study and this led to development of degenerative theory, that consider almost ruptured AT develop on top of pathological one. Conclusion MRI is a gold standard and important diagnostic tool in the evaluation of AT lesions especially in chronic and complex cases, and who do not respond to conservative measures and provides precious information for surgical intervention in parallel with careful clinical examination. Full thickness tear and partial thickness tear may develop on top of pathological tendon.

Sono-Elastography in evaluation of the median nerve in carpal tunnel syndrome patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Mohamed Abdelraouf ◽  
Amal Ibrahim Ahmed ◽  
Nouran Abdelrahman Elghitany
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Area Under Curve ◽  
University Hospitals ◽  
Electrodiagnostic Testing ◽  
Study Population ◽  
Tunnel Syndrome ◽  
Study Setting

Abstract Background Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. It is caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. The diagnosis of CTS is based on a combination of characteristic symptoms and electrophysiologic abnormalities. Electrodiagnostic testing (EDT) is uncomfortable for patients, time consuming and expensive. Objective To evaluate the role of greyscale and strain elastography ultrasound imaging in diagnosing patients with CTS and controls in comparison with nerve conductive studies. Patients and Methods Type of Study: Descriptive, prospective study. Study Setting: The study will be conducted at Ain Shams University Hospitals, Radiodiagnosis department. Study Period: 6 months. Study Population: Patients with carpal tunnel syndrome diagnosed clinically and underwent nerve conduction velocity study. Results In this study 7 wrists were diagnosed with mild CTS, 5 wrists demonstrated moderate CT, whereas only 3 wrists revealed severe CTS. The mean CSA would have increased if the number of cases with severe CTS had been higher. CSA of the median nerve has been reported to increase with the severity of entrapment. The cut off point of the average CSA to differentiate between cases and controls was found > 8 with sensitivity of 93.33%, specificity of 80% and area under curve (AUC) of 91.3% while the best cut off point for Elasto score was found > 1 with sensitivity of 86.6%, specificity of 80% and area under curve (AUC) of 93.3%. Conclusion We concluded that sonoelastography is a sensitive tool for prediction of CTS and it’s severity in correlation to NCV.

scholarly journals The Privilege of Proton Magnetic Resonance Spectroscopy in Evaluating Ovarian Tumors

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Hafez ◽  
M A Nasr ◽  
N L Salman
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Malignant Tumors ◽  
Radiology Department ◽  
Invasive Technique ◽  
Resonance Spectroscopy ◽  
Ovarian Mass ◽  
University Hospitals ◽  
Non Invasive

Abstract Background Exclusion of malignancy in ovarian mass is of paramount importance. It is the most crucial step after identification of a mass and it has a profound effect on the patient's management. So, a reliable method with which to differentiate a benign from a malignant ovarian mass would provide a basis for optimal preoperative planning and may also reduce the number of unnecessary laparotomies for patients undergoing treatment for benign disease. Objective The aim of our study is to highlight the role of magnetic resonance spectroscopy as a non-invasive technique which may effectively assist in differentiating benign from malignant ovarian masses. Patients and Methods This study included 20 patients with adnexal masses as suggested by preliminary pelvic ultrasound examination. referred from the Gynecology Department to the Radiology Department at Ain shams university hospitals. nine were benign, two were borderline, and six were malignant tumors and 3 were hemorrhagic cyst. Endometriosis, tubo-ovarian abscess. Results Our study revealed sharp choline peak in some benign as well as some malignant cases and so Cho peak could not help in the differential diagnosis between benign and malignant tumors, creatine, lipid and NAA were detected in both benign and malignant tumors, also Choline/Creatine Ratio fairly can differentiate between benign and malignant tumors with cut off point = 3.750 at sensitivity = 75.0% & specificity = 100.0% . Conclusion Our study had some factors that affect the results. First, the sample size were not enough to achieve a good results, second, diversity of samples and the complicated tumor histopathologic and morphologic features.

scholarly journals Management of facial burns

2020 ◽  
Vol 8 ◽  
Author(s):  
David G Greenhalgh
Keyword(s):  
Skin Grafting ◽  
Healing Time ◽  
The Body ◽  
Full Thickness ◽  
Partial Thickness ◽  
Facial Burns ◽  
The Face ◽  
Partial Thickness Burns

Abstract Burns to the face affect a part of the body that cannot be hidden and thus exposes potentially major changes in appearance to society. Therefore, it is incumbent upon the caregiver to optimize healing and minimize scarring. The goal for partial-thickness burns is to have them heal within 2–3 weeks to minimize healing time. For full-thickness burns there needs to be strategies to optimize the outcomes for skin grafting and minimize scarring. The goal of this review is to discuss the best way to improve the outcomes of these devastating injuries.

scholarly journals Chronic non-traumatic shoulder pain: evaluation with ultrasonography and conventional mr imaging

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M N Elaassar ◽  
A Emadeldin ◽  
D Z Zidan ◽  
H M Sakr ◽  
H Abdelazim
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Shoulder Joint ◽  
Supraspinatus Tendon ◽  
Radiology Department ◽  
Dominant Hand ◽  
Full Thickness ◽  
Duration Of Symptoms ◽  
Partial Thickness ◽  
Chronic Shoulder Pain

Abstract Background Shoulder pain is a common and disabling complaint. It is responsible for approximately 16 % of all musculoskeletal disorders1 Shoulder pain is defined as chronic when it has been present for longer than six months, regardless of whether the patient has previously sought treatment2. The most common causes of chronic shoulder pain are reported to be rotator cuff disorders, acromioclavicular joint (ACJ) disease and glenohumeral joint (GHJ) disorders3 Aim of the Work The aim of this study is to evaluate the role of both ultrasonography and conventional MRI imaging in diagnosing various causes of chronic shoulder pain not caused by trauma. Patients and Methods 101 patients were evaluated for chronic shoulder pain ranging in age from 20 to 70-years-old. They were referred to the radiology department (Ultrasound unit and MRI unit) at Ain Shams University hospitals during the period between September 2016 and June 2018, from orthopaedic, rheumatology and physical medicine departments. Once a patient satisfied the inclusion and exclusion criteria for this study, an elaborate history was taken from all the patients which was followed by a thorough clinical evaluation, in which duration of symptoms, affected side, dominant hand, range of movement was checked. Patients were subjected to sonographic evaluation of the shoulder joint followed by MRI of the affected shoulder with mean interval between sonography and MRI about 10 days (range, 5-15 days). Results Total of 101 patients with chronic shoulder joint pain were enrolled in our study. 58 % of the patients were in the age group of 41-55 years with mean age of 48 years. Majority (42 %) of patients had chronic shoulder pain over 6-9 months. Complaints mainly resided in the form of tenderness (65 %) and night pain (25 %). Females constituted most of the patients around 68% of the cases. Majority (72%) patients in our study had right hand dominance. 57 % of the sampled patients gave positive history of heavy use of the affected shoulder. 78 % of patients demonstrated acromion morphological changes that had a direct impact on the rotator cuff findings. Amongst the rotator cuff tendons, Supraspinatus tendon was the most common tendon to be involved in our study in both USG and MRI. USG detected 92 patients and MRI detected 96 patients with supraspinatus tendon pathologies which included tendinosis, tears and calcifications and other non-rotator-cuff related findings. Total of 53 were diagnosed as rotator cuff-tear, followed by subacromial-subdeltoid bursitis (n = 32), supraspinatus impingement (n = 14), calcific tendinitis (n = 7) respectively. Supraspinatus tendinopathy was the most common diagnoses (n = 51) followed by Partial thickness tear of supraspinatus (n = 19) then full thickness of supraspinatus (n = 17). USG showed a sensitivity of 52.6% and specificity of 87.8 %, NPV of 88.9 % and PPV of 50 % with 78.8 % MRI agreement for partial thickness tears. USG showed 88 % sensitive, 97% specific, had 97 % PPV, 100% NPV, and was 96 % accurate in diagnosing complete tendon tear. MRI had a higher efficacy for both full thickness as well as partial thickness tears, whereas USG had a higher efficacy for full thickness tears only. Our study shows MRI to be a highly sensitive as well as specific technique for differentiation among different shoulder pathologies.

scholarly journals Role of Ultrasound Guided Injection of Platelet Rich Plasma (PRP) in Rotator Cuff Tendinopathy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G M Niazy ◽  
A H Ali ◽  
M S S Mahmoud
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Radiology Department ◽  
P Value ◽  
Ultrasound Guided ◽  
University Hospitals ◽  
Significant Difference ◽  
Tendon Thickness ◽  
Rotator Cuff Tendinopathy

Abstract Background Rotator cuff tendinopathy is a leading cause of shoulder pain and a significant source of disability. It is a common disorder, with its prevalence increasing substantially with age and affecting more than 50% of the general population by the age of 60 years Objectives Based on these facts, our study efforts seeked assessment of the role of ultrasound guided platelet rich plasma injection (PRP) in cases of rotator cuff tendinopathy. Patients and Methods Type of Study is single arm interventional study was conducted in Ain shams university hospitals in the period between October 2018 and March 2019, 15 patients were included in the study ranging from 25 to 60 years old, were referred to the Radiology department at Ain Shams University Hospitals. Study Setting: all US examinations were performed by the same senior musculoskeletal radiologist with a large experience in the musculoskeletal US at the radiology department of Ain Shams University hospitals. Study Period: 6 months for data collection. Results Our study showed remarkably noticeable change on comparing the pre-injection and post-injection SPADI Scoring system at 4,8,12 and 24 weeks. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow up at 4, 8 and 12 weeks while only there was statistically significant decrease in tendon thickness found at 24 weeks with p-value = 0.043. Conclusion The ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modalities outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy. It deserves our attention to its value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life.

scholarly journals 4221 Lower Serum TWEAK Concentration is a Biomarker for Mortality in Community Acquired Pneumonia

2020 ◽  
Vol 4 (s1) ◽  
pp. 139-139
Author(s):  
Daniela Parra ◽  
Manuela Sáenz-Valcárcel ◽  
Laura Claverias ◽  
Sandra Trefler ◽  
María Bodí ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
University Hospitals ◽  
Underdeveloped Countries ◽  
Icu Admission ◽  
Inflammatory Processes ◽  
Study Population ◽  
The Relationship

OBJECTIVES/GOALS: To determine the relationship among serum concentration of tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and mortality in community-acquired pneumonia (CAP) patients. METHODS/STUDY POPULATION: This is a multicenter 2-year cohort study in Spain, designed to better understand the role of sTWEAK concentrations in CAP patients. CAP patients were prospectively enrolled in two University hospitals and sTWEAK was measured within the first 24 hours of ICU admission. Samples were collected and stored for laboratory analyses. To detect sTWEAK in human samples, we used a commercially available ELISA kit following manufacturer’s instructions. Demographic patients’ characteristics and ICU mortality were prospectively collected. Descriptive statistics and logistical regressions were used to assess the proposed aims. RESULTS/ANTICIPATED RESULTS: A total of forty-three patients were included in the study (10 healthy users, 10 uninfected controls and 23 CAP patients). In comparison to healthy volunteers, patients admitted to the hospital (both, infected and non-infected) had lower level of sTWEAK. During hospital admission, 7 (17%) patients died. Patients whom died during ICU stay due to CAP, had significantly lower levels of sTWEAK when comparing with patients whom survived (Median [IQR]; 509.35 [357.49, 953.92] Vs 1103.03 [716.93, 1663.16]; p = 0.015). In contrast, patients that developed shock did not have different concentrations of sTWEAK (Median [IQR]; 1008.04 [531.87, 1390.80] Vs 1062.29 [575.24, 1598.83], p = 0.84). DISCUSSION/SIGNIFICANCE OF IMPACT: Community-acquired pneumonia (CAP) is the first cause of death in underdeveloped countries. CAP is a pulmonary infection that creates a proinflammatory environment not just locally but also systemically, secondary to upregulation of molecular cascades with a wide variety of proteins being released perpetuating this inflammation and tissue damage. Several of these molecules have been described and linked to a greater risk of inhospital complications, longer length of hospital stay and mortality. TNF-like weak inducer of apoptosis (TWEAK) is a member of the TNF-alpha superfamily, involved in immune response, cell growth, angiogenesis, NF-kB activation and apoptosis induction in tumor cells. It is known that serum-TWEAK plays a role in inflammatory processes, however, its behavior is unknown in patients with CAP. Therefore, this study aims to identify whether there is a relationship between serum concentration of TWEAK and prognosis in CAP patients. To our knowledge, this is the first study to shown that concentration of sTWEAK within the first 24 hours of ICU admission is lower in patients with CAP. Moreover, patients whom died during ICU admission due to CAP, have lower sTWEAK levels. This biomarker may identify patients at higher risk of dying due to CAP and may represent severe CAP. However, further studies are needed to confirm these findings.

scholarly journals Awareness on Nut Allergies Among School Students

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1023-1026
Author(s):  
Trisha ◽  
Dhanraj Ganapathy ◽  
Keerthi Sasanka
Keyword(s):  
Immune System ◽  
Signs And Symptoms ◽  
The Body ◽  
Severe Allergic Reaction ◽  
Food Protein ◽  
School Students ◽  
Study Population ◽  
Survey Results ◽  
Self Administered Questionnaire

The role of the immune system is to protect the body from germs and diseases. A food allergy is the overreaction by the immune system to a food protein. People are allergic to many kinds of food, majorly nuts. Anaphylaxis is a severe allergic reaction that comes on quickly and could even cause death in certain cases. The aim of this study was to assess awareness on nut allergies and to study the already existing knowledge on the topic among school students. Self administered questionnaire was created based on the awareness of the presence of nut allergy, their signs and symptoms. The questionnaire was distributed by person as fill out sheets at a nearby school. The study population included 200 school students belonging to the age group of 8 to 16 and years. The questions were carefully studied and corresponding answers were marked by the participants. The data was collected and statistically analysed. According to the survey results, about 81% of the total school population were aware about the presence of nut allergy. About 85% voted prevention is better to manage nut allergy.70.8% were aware of signs and symptoms of nut allergy .63% said their family members or friends have some kind of allergy to various nuts. Most of the school students had the knowledge and were aware about the presence of nut allergies, but more awareness has to be spread as the allergies could turn out to be very serious or even fatal and can only be controlled only through prevention.

Potential Role of PET/CT in Evaluation of Thyroid Carcinoma Subtypes

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Yara Mohamed Fahmy ◽  
Tougan Taha Abd El Aziz ◽  
Marwa El Sayed Abd El Rahman
Keyword(s):  
Thyroid Carcinoma ◽  
Risk Stratification ◽  
Lymph Nodes ◽  
Radiology Department ◽  
University Hospitals ◽  
18Fdg Pet ◽  
Pet Ct ◽  
The Mean

Abstract Background Thyroid carcinoma is the most common endocrine malignancy. The biology of its different subtypes differ dramatically leading to different treatment approaches. Role of 18FDG PET/CT in thyroid carcinoma is still highly debated and not well established. Its indications are still being investigated in the hope of utilizing it in diagnosis, risk stratification, and follow up of thyroid carcinoma patients. Objective To explore the role of 18FDG PET/CT in the evaluation of different subtypes of thyroid carcinoma. Methods A retrospective descriptive study over the course of 9 months from July 2018 till March 2019. It included patients with pathologically proven thyroid carcinoma referred to the Radiology department, Ain Shams University Hospitals for a 18FDG PET/CT scan. Results 18FDG PET/CT scans of 16 patients were included in the study. Fourteen (87.5%) patients underwent thyroid surgery, two of whom (14.3%) displayed local operative bed recurrence. Eight patients (50%) were diagnosed with nodal disease of whom four patients (50%) had necrotic lymph nodes displaying average SUVmax of 3.7 (±1.3) compared to four patients (50%) with non-necrotic lymph nodes that achieved average SUVmax of 10.7 (±12.3). The mean SUVmax of the most metabolically active lymph nodes in patients who received chemotherapy was 3.5 compared to 7.7 in those who didn’t. On the other hand, the mean SUVmax of the most metabolically active lymph nodes in those who received radioactive iodine therapy was 3.2 compared to 14.2 in those who didn’t. Distant metastasis were detected in two (12.5%) patients. Conclusion The role of 18FDG PET/CT in thyroid malignancy remains unclear and controversial, whether in diagnosis, staging, risk stratification, follow up, or detection of recurrence. Further evaluation the role of 18FDG PET/CT in thyroid carcinoma is required. Moreover, more investigation particularly in the less common subtypes is warranted to provide a more comprehensive guideline for the use of 18FDG PET/CT in various subtypes of thyroid carcinoma.

The Role of Polyphenols in the Modulation of Plasma Non-Enzymatic Antioxidant Capacity (NEAC)

2012 ◽  
Vol 82 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Mauro Serafini ◽  
Giuseppa Morabito
Keyword(s):  
Antioxidant Capacity ◽  
Dietary Intervention ◽  
Ex Vivo ◽  
The Body ◽  
Dietary Polyphenols ◽  
Enzymatic Antioxidant ◽  
Endogenous Antioxidant

Dietary polyphenols have been shown to scavenge free radicals, modulating cellular redox transcription factors in different in vitro and ex vivo models. Dietary intervention studies have shown that consumption of plant foods modulates plasma Non-Enzymatic Antioxidant Capacity (NEAC), a biomarker of the endogenous antioxidant network, in human subjects. However, the identification of the molecules responsible for this effect are yet to be obtained and evidences of an antioxidant in vivo action of polyphenols are conflicting. There is a clear discrepancy between polyphenols (PP) concentration in body fluids and the extent of increase of plasma NEAC. The low degree of absorption and the extensive metabolism of PP within the body have raised questions about their contribution to the endogenous antioxidant network. This work will discuss the role of polyphenols from galenic preparation, food extracts, and selected dietary sources as modulators of plasma NEAC in humans.

The Role of Computer Modeling in Electrocardiography

1990 ◽  
Vol 29 (04) ◽  
pp. 282-288 ◽  
Author(s):  
A. van Oosterom
Keyword(s):  
Electrical Activity ◽  
Computer Modeling ◽  
Body Surface ◽  
Electrical Current ◽  
The Body ◽  
Volume Conductor ◽  
Current Generator ◽  
Cardiac Electrical Activity ◽  
Source Models

AbstractThis paper introduces some levels at which the computer has been incorporated in the research into the basis of electrocardiography. The emphasis lies on the modeling of the heart as an electrical current generator and of the properties of the body as a volume conductor, both playing a major role in the shaping of the electrocardiographic waveforms recorded at the body surface. It is claimed that the Forward-Problem of electrocardiography is no longer a problem. Several source models of cardiac electrical activity are considered, one of which can be directly interpreted in terms of the underlying electrophysiology (the depolarization sequence of the ventricles). The importance of using tailored rather than textbook geometry in inverse procedures is stressed.

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