Insulin resistance and endocrine-metabolic abnormalities in polycystic ovarian syndrome: comparison between obese and non-obese PCOS patients

Background: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome [PCOS]. Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients

Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women

Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese [BMI >/=25] and 45 patients were non-obese [BMI <25]. Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant

Results: There was no significant difference in presence of insulin resistance [HOMA-IR >2.3] between two groups [p=0.357]. Waist circumference [p<0.001], waist/hip ratio [p<0.001], systolic [p<0.001] and diastolic [p<0.001] blood pressures, fasting blood sugar [p=0.003] and insulin [p=0.011], HOMA-IR [p=0.004], total cholesterol [p=0.001] and triglyceride [p<0.001] were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone [p=0.634] and androstenedione [p=0.736] between groups whereas Dehydroepiandrotendione sulfate [DHEAS] was significantly higher in non-obese PCOS women [p=0.018]. There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively

Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients

Incidental findings in patients evaluated for pulmonary embolism using computed tomography angiography

Introduction: Pulmonary embolism [PE] is a common lethal disease that its clinical symptoms may be seen in many other diseases. Computed tomography pulmonary angiography [CTPA] is a valuable diagnostic modality for detection of PE. In addition, it can accurately detect the other diseases with clinical symptoms similar to PE. The aim of this study is to evaluate the frequency of PE and nonembolic disease with similar clinical symptoms including pulmonary, pleural, mediastinal, and cardiovascular diseases that have been detected by CTPA and to describe the importance of reporting these CT findings

Materials and Methods: In this cross-sectional study, we evaluated the medical records of CTPA in 300 patients of suspected PE between March 2012 and February 2013 in Imam Reza Hospital and Ghaem Hospital in Mashhad University of Medical Sciences, Mashhad, Iran. Demographic information and the results of CTPA of these patients were re-evaluated. One radiologist reviewed all of the CTPA and the results have been analyzed by SPSS-16 soft

Results: In this study, PE was detected in 18.7% of patients. Multiple incidental imaging findings were diagnosed as follow: pulmonary consolidation [33.2%], pleural effusion [48.7%], pulmonary nodules [10%], pulmonary masses [1.3%], pneumothorax [4.7%], mediastinal mass and lymphadenopathy [9.3%], aortic calcification [42%], coronary arteries calcification [27.3%], mitral valve calcification [2 %], cardiomegaly [30.7%], and the evidences of right ventricular dysfunction [6.7%]

Conclusion: A group of disease can cause the clinical symptoms similar to that of PE. Among them, pulmonary consolidation and pleural effusion have much higher frequency than PE. In addition, CTPA can show pathologic findings in the patients that need follow-up. It is important to detect and report these imaging findings because some of them may change the treatment and prognosis of patient who are suspected to have PE

role of nuclear medicine in the diagnosis and management of solitary pulmonary nodules

Solitary pulmonary nodule [SPN] is a frequent finding on the chest x-ray and computed tomography. Nuclear medicine techniques play an important role in the diagnosis and management of SPN. In the current review, we briefly will explain the different nuclear medicine modalities in this regard including positron emission tomography [PET] using 18-F-FDG, and 11-C-Methionine, and single photon emission computerized tomography [SPECT] using somatostatin receptor scintigraphy, 201-Thallium, and 99m-Tc-MIBI