Comparison of Computed Tomography Findings between Adult and Pediatric COVID-19 Patients.

PURPOSE: This study aims to compare chest computed tomography (CT) findings between adult and pediatric patients with coronavirus disease-19 (COVID-19) pneumonia. MATERIALS AND METHODS: This study included 30 pediatric patients aged 1 to 17 years and 30 adult patients over 18 years of age with COVID-19 pneumonia confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) who have findings related to COVID-19 on Chest Computed Tomography. The CT findings of adult and pediatric patients were compared with a z-test. RESULTS: Bilateral involvement (p:0.00056), involvement in all five lobes (p<0.00001), and central and peripheral involvement (p:0.01928) were significantly higher in the adult group compared to the pediatric group. In the pediatric group, the frequency of unilateral involvement (p:0.00056), involvement of solitary lobe (p:0.00132), and peripheral involvement (p: 0.01928) were significantly higher than in the adult group. The most common parenchymal finding in adults and pediatric patients was ground-glass opacities (100% and 83%, respectively). Among the parenchymal findings in adults, ground-glass opacities with consolidation (63%) were the second most common finding, followed by air bronchogram (60%) in adults, while in pediatric patients, halo sign (27%) and nodule (27%) were the second most common, followed by the ground-glass opacities with consolidation (23%). CONCLUSION: The CT findings of pediatric COVID-19 patients must be well-known as the course of the disease is usually less severe, and the radiological findings are uncertain when compared with adults.

Masseter Muscle Thickness And Elasticity in Bruxism After Exercise Treatment: A Comparison Trial.

OBJECTIVE: The purpose of this study was to evaluate the effects of Rocabado's 6 × 6 exercises on masseter muscle thickness, muscle elasticity, and pain scores in patients with bruxism. METHODS: A total of 58 participants with bruxism were divided into 2 groups as the exercise group (EG) and control group (CG). A self-care program was applied for the participants in the CG. For those in the EG, in addition to the self-care program, an exercise treatment was performed for 6 days per week for a total of 8 weeks. Using ultrasonography, bilateral masseter muscle thickness and elasticity were assessed before and after treatment. Pain was measured using a visual analog scale. Changes over time within the groups and group-time interactions for continuous variables were assessed using mixed 2-way repeated measures analysis of variance. RESULTS: The improvement in muscle elasticity (P = .015; P = .004) and pain values (P = .049; P = .040) were greater in the EG compared with the CG. There was no significant difference between the 2 groups for masseter muscle thickness (P > .05). CONCLUSION: This study suggests that Rocabado's 6 × 6 exercises are effective in the treatment of muscle elasticity and pain values in participants with bruxism.

Computed tomography findings of COVID-19 in pediatric patients.

BACKGROUND: In this study, we aimed to evaluate the thorax Computed Tomography (CT) findings of pediatric patients diagnosed with coronavirus disease-19 (COVID-19) and to discuss these findings in light of the results of adult patients from the literature. METHODS: The CT scans of pediatric patients (1-18 years old) with a diagnosis of COVID-19 by reverse transcriptase-polymerase chain reaction (RT-PCR) in our hospital between March 2020 and January 2021 were retrospectively reviewed. The scans were interpreted regarding the distribution and localization features, and involvement patterns including ground-glass opacity, consolidation, halo/reversed halo sign, interlobular septal thickening, air bronchograms and bronchiectasis. The frequencies of these findings in pediatric cases in our study were recorded. RESULTS: A total of 95 patients with a mean age of 13±4.6 years were included in this study. Among them, 34 (36%) had lesions associated with COVID-19 on CT scans. Bilateral involvement was detected in 15 (44%) while unilateral in 19 (56%) patients. Eighteen (53%) patients had single lobe involvement. In 16 (47%) patients a solitary lesion was detected and in 18 (53%) multiple lesions were present. Ground-glass opacity appearance was observed in 28 (82%), consolidation in 9 (26%), and ground-glass opacity with consolidation in 8 (24%), halo sign in 9 (26%), reversed halo sign in 2 (6%), interlobular septal thickening (interstitial thickening) in 1 (3%) patients. CONCLUSIONS: As symptoms are relatively milder in children with COVID-19, CT findings are less extensive than in adults. It is essential to know the thorax CT findings that aid in the diagnosis and follow-up of the disease.

The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain.

Patients with nonspecific low back pain (NSLBP) may face motor control problems and health disability barriers during various tasks. However, studies investigating the extent of these disadvantages, and possible associated factors are quite limited in patients with NSLBP. To compare motor control performances and physical assessment domains between patients with NSLBP and asymptomatic controls. Twenty-seven patients with NSBLP and 27 age- and sex-matched asymptomatic controls participated in this cross-sectional study. Ultrasonographic imaging was used to determine abdominal and multifidus muscles thicknesses and adipose tissue rate. Visual analog scale was used to assess LBP severity. Body mass index (BMI) and Oswestry Disability Index (ODI) scores of the participants were physical assessment domains of LBP. BMI values were greater in the NSLBP group compared to the asymptomatic participants. ANCOVA revealed a significant interaction effect regarding external abdominal oblique and multifidus lumborum muscles thickness, and abdominal adipose tissue (p = 0.015; p = 0.001; p = 0.006), respectively in terms of two groups. The thicknesses of these muscles were lesser in the NSLBP group compared with the control group. Similarly, abdominal adipose tissue was higher in the NSLBP group. The stepwise multiple regression analysis demonstrated that the Oswestry Disability Index and abdominal adipose tissue rate were significant and independent factors of the low back pain severity with 73.5% of the variance. The study results indicate that increased disability and fat infiltration are possible determinants influencing pain severity, although further research is required. Examining musculoskeletal properties of lumbar region could provide information about the limitation in patients with NSBLP.

Are Biomechanical Features of the Foot and Ankle Related to Lumbopelvic Motor Control?

BACKGROUND: Any pathomechanical change in the foot or ankle is expected to cause adverse biomechanical effects on the lumbopelvic region. However, no objective data can be found in the literature regarding the effects of musculus transversus abdominis (mTrA) and musculus lumbar multifidus (mLM), which are effective muscles in lumbopelvic motor control, or regarding the extent of their effects. METHODS: Sixty-four healthy young adults were assessed by a physiotherapist (C.K.) experienced in treating feet and a radiologist (Y.D.) specialized in muscular imaging. In the determination of biomechanical properties of the foot, the navicular drop test (NDT), Foot Posture Index (FPI), pedobarographic plantar pressure analysis, and isokinetic strength dynamometer measurements were used in determining the strength of the muscles around the ankle. Ultrasonographic imaging was used to determine mTrA and mLM thicknesses. RESULTS: Significant correlation was found between NDT results and mTrA and mLM thicknesses (P < .05) and between FPI results and mTrA thicknesses (P < .05). As the peak pressure of the foot medial line increased, mTrA and mLM thicknesses decreased (P < .05). Although dorsiflexion muscle strength was also effective, mTrA and mLM thicknesses were found to increase especially as plantarflexion muscle strength increased (P < .05). CONCLUSIONS: These results show that the biomechanical and musculoskeletal properties of the foot-ankle are associated with lumbopelvic stability.

Does Plantar Pressure Distribution Influence the Lumbar Multifidus Muscle Thickness in Asymptomatic Individuals? A Preliminary Study.

BACKGROUND: Atrophy can occur in the lumbar multifidus (LM) muscle quickly as a result of various musculoskeletal problems. Knowing factors influencing muscle thickness of the LM will provide important clues about lumbopelvic stability. OBJECTIVES: Although there are several studies in the literature investigating the adverse effects of foot-ankle postural disorders on the lumbopelvic region, to our knowledge there has been no investigation of plantar pressure distribution (PPD) as a factor influencing muscle thickness of the LM. The aim of this study was to determine whether PPD could affect LM muscle thickness. METHODS: This observational study consisted of 25 asymptomatic individuals. Ultrasonographic imaging was used to determine the thickness of the LM. All participants were subjected to PPD analysis using the Digital Biometry Scanning System and Milletrix software in 9 different plantar pressure zones. The Pearson product-moment correlation coefficients were used to examine the correlations between the LM muscle thickness and other variables. Stepwise multiple linear regression analysis was used to determine the variables with the greatest influence on LM muscle thickness. RESULTS: Peak pressures of medial and lateral zones of the heel were the significant and independent factors influencing static LM thickness, with 39.5% of the variance; moreover, the peak pressures of heel medial and fourth metatarsal bone were the significant and independent factors influencing dynamic LM thickness, with 38.7% of the variance. CONCLUSIONS: Plantar pressure distribution could be an important factor influencing LM thickness, although further research is required. Examining foot-ankle biomechanics may provide information about the stability of the LM.

Traumatismo cerrado menor, gran lesión renal en un paciente pediátrico; curación después de caterización ureteral / Minor blunt trauma, major kidney injury in a pediatric patient; healing after ureteral stenting

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Retrospective evaluation of patients with organizing pneumonia: is cryptogenic organizing pneumonia different from secondary organizing pneumonia?

INTRODUCTION: Organizing pneumonia (OP) is an uncommon clinic opathological situation among lung diseases. If no underlying cause can be detected, it is named as cryptogenic OP (COP). In this study, the etiologic and clinical characteristics of patients diagnosed as OP in our hospital in the last ten years were evaluated retrospectively. It was also aimed to make a comparison between COP and secondary OP patients. MATERIALS AND METHODS: One hundred sixty-five patients diagnosed as OP pathologically in the 10 year period from August 2003 to August 2013 were included into that study. Patients' data were evaluated retrospectively from the medical records. RESULT: One hundred sixty five patients pathologically diagnosed as OP were included. Diagnostic methods were trans-thoracic fine-needle biopsy (TTFNB) in 89 (53.9%) patients, open lung biopsy (lobectomy, wedge resection, segmentectomy) in 52 (31.5%) patients and transbronchial biyopsy (TBB) in 24 (14.5%) patients. One hundred (60.6%) of the patients were defined as COP and 65 (39.4%) as secondary OP. Cough, fatigue and dyspnea were the most common symptoms on admission. We detected OP cases secondary to anthracosis and cyst hydatic besides other well known etiologies. In 61 patients, the main radiologic manifestation was multiple bilateral patchy consolidation typical for OP. In 76 patients focal lesions (solid mass, cavitating mass lesion) and in 6 patients infiltrative opacities were detected radiologically. CONCLUSIONS: There is no difference between properties of OP from clinical, laboratory and radiologic finding sin the criptogenic and seconder form of OP. Although it is not asserted, cyst hidatic and anthracosis could be kept in mind for the list of underlying ethiologies for secondary OP.

Role of Ultrasonography in Detecting the Localisation of the Nasoenteric Tube.

OBJECTIVE: In this study, we aimed to determine the success rate of nasoenteric tube (NET) insertion into the postpyloric area using ultrasonography (USG) and compare with the commonly used method direct abdominal graphy. METHODS: A single anaesthesiologist placed all the NETs. The NET was visualised by two radiologists simultaneously using USG. The localisation of the tube was confirmed using an abdominal graph in all patients. RESULTS: The blind bedside method was used for NET insertion into 34 patients. Eleven of the tubes were detected passing through the postpyloric area using USG. In one case, the NET could not be visualised in the postpyloric area using USG; however, it was detected in the postpyloric area through control abdominal radiography. In 22 patients, NETs were detected in the stomach using control abdominal radiography. The rate of imaging post pyloric using USG was 91.6%. When all cases were considered, catheter localisation was detected accurately using USG by 97% (33 in 34 patients). CONCLUSION: USG is a reliable and practical alternative to radiography, which can be used to detect localisation of the nasogastric tube and NET.