Medicine
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The purpose of this phantom study is to compare radiation dose and image quality of abdominal computed tomography (CT) scanned with different tube voltages and tube currents, reconstructed with filtered back projection (FBP), hybrid iterative reconstruction (IR) and deep learning image reconstruction (DLIR) algorithms. A total of 15 CT scans of whole body phantoms were taken with 3 different tube voltages and 5 different tube currents. The images were reconstructed with FBP, 30% and 50% hybrid IR adaptive statistical iterative reconstruction (ASIR-V), and low, medium and high strength DLIR algorithms. ⋯ The DLIR algorithms generated better quality images than ASIR-V algorithms in all the data sets. In addition, among the data sets reconstructed with DLIR algorithms, image quality was the best at the medium strength level, followed by low and high. This phantom study suggests that DLIR algorithms may be considered as a new reconstruction technique by reducing radiation dose while maintaining the image quality of abdominal CTs.
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Hepatocellular with tumor thrombi extending into 3 hepatic veins (HVs) and right atrium presents as a real clinical challenge. We report the first documented case of surgical resection of an advanced hepatocellular carcinoma (HCC) with extensive invasion to distal stomach, atrium and hepatic vasculatures. ⋯ This case illustrates that the extensive invasion of HCC to major vasculature and adjacent organs may not necessarily preclude the liver autotransplantation with multi-visceral resection as the treatment option of extremely advanced HCC patients.
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Observational Study
Determinants of first-line biological treatment in patients with rheumatoid arthritis: Results from an observational study.
Guidelines for the treatment of rheumatoid arthritis (RA) recommend the use of conventional synthetic disease modifying anti-rheumatic drugs (cs-DMARDs) at the onset of the disease and only in the case of therapeutic failure, the addition of a biological drug (b-DMARD) is suggested. The study aimed to evaluate determinants for first-line biological treatment in patients with RA in clinical practice. A cohort of patients with RA, resident in Lazio, a central Italian Region, where Rome is located, and with at least one disease modifying anti-rheumatic drugs (DMARD) prescription between 2010 and 2016 was selected using health information systems linkable with each other by an individual unique anonymous identifier. ⋯ In the first year of treatment, we observed a percentage of switch from cs-DMARDs to b-DMARDs of 7.9%. In clinical practice, about 7% of patients with RA are prescribed with a b-DMARD as first-line treatment. This therapeutic option, even if not supported by guide lines, is mostly link to younger age and clinical profile of the patients.
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Observational Study
Stature estimation for Saudi men based on different combinations of upper limb part dimensions.
Estimating stature based on body/limb parts can help define the characteristics of unidentified bodies. The most studied upper limb part is the hand, although few studies have examined whether stature can be estimated using fingers plus other hand dimensions. Moreover, there is paucity in anthropometric studies that determined whether bilateral whole limb parts (e.g., arms, forearms, and hands) are related to stature among the living subjects. ⋯ A multiparameter model provided reasonable predictive accuracy (±3.77-5.68 cm) and was more accurate than single-parameter models. Inclusion of the right-side fingers improved the model's accuracy. This study developed potential models for estimating stature during the identification of bodies of Saudi men.
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Observational Study
The influence of RS738409 I148M polymorphism of patatin-like phospholipase domain containing 3 gene on the susceptibility of non-alcoholic fatty liver disease.
We aimed to elucidate the frequency of polymorphic genotypes and alleles of patatin-like phospholipase domain containing 3 rs738409 polymorphism and its possible associations with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis in a cohort from Turkey. We enrolled 200 patients diagnosed with NAFLD and genotyped for rs738409 I148M polymorphism by real-time polymerase chain reaction, particularly by melting curve analysis. SPSS analysis software was used for statistical significance. ⋯ Our results demonstrate in a cohort from Turkey that rs738409 C > G polymorphism (I148M) of patatin-like phospholipase domain containing 3 gene is significantly able to affect individuals to have NAFLD in unadjusted regression model. Consistent with the previous studies in other populations, our study group showed a significantly higher risk of having NAFLD in unadjusted regression model but not in the adjusted model indicating that non-genetic factors such as age and sex may be responsible for the association. However, independent studies need to validate our findings with a larger group of NAFLD patients, as well as in different ethnic cohorts.