Recent advancements in 18F-FDG PET/CT for the diagnosis, staging, and treatment management of HIV-related lymphoma.

Infection with the Human Immunodeficiency Virus (HIV) is one of the most pressing issues facing public health on a worldwide scale. Currently, HIV-related lymphoma is the most common cause of death among people living with HIV, and warrants more attention. The unique challenges associated with HIV-related lymphoma management derive from the underlying HIV infection and its immunosuppressive effects. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has gained significant prominence in the past few years as a valuable diagnostic and therapeutic instrument for the treatment of HIV-related lymphoma. This review will start with an overview of the subtypes, risk factors, and therapeutic choices for individuals with HIV-related lymphoma. We will then briefly discuss the current application of 18F-FDG PET/CT in the medical management of HIV-related lymphoma patients, followed by the initial staging of the disease, the evaluation of therapeutic response, the prediction of prognostic outcomes, the decision-making process for radiotherapy guided by PET findings, and the distinguishing of various diagnoses.

Dehydrogenase (DLD) Deficiency in an Iranian Patient with Recurrent Intractable Vomiting: Successful Treatment with Thiamine Supplementation.

Dihydrolipoamide dehydrogenase (DLD) deficiency is a rare disease of genetic origin due to the malfunctioning of a shared subunit of three mitochondrial multi-enzyme complexes. Phenotypes of this disease are a set of clinical manifestations ranging from neonatal disorders to myopathy or recurrent episodes of liver failures, and vomiting for which no adequate or definitive treatment is currently available. This study described a case involving a 16-year-old boy who had experienced recurrent vomiting of unknown cause from age two. Normal value ranges for the basic metabolic panel were reported in previous years. The patient was admitted with Wernicke's encephalopathy after the last vomiting attack, also indicating metabolites of organic acids compatible with DLD deficiency. Whole exome sequencing identified a known pathogenic mutation in the DLD gene, leading to a diagnosis of DLD deficiency. Our patient was treated with a high dose of thiamine supplementation and continued treatment, has not experienced any vomiting attacks or related problems in the last two years and has adequately responded to the treatment prescribed. Normal urine organic acid levels in patients with recurrent vomiting cannot roll out DLD deficiency. However, although thiamine deficiency typically induces Wernicke's encephalopathy, it can also be implicated in pyruvate dehydrogenase complex (PDHc) deficiency, and high-dose thiamine therapy (with doses up to 30 mg/kg) is recommended for deficient patients.

Correlation of magnetic resonance spectroscopy and magnetic resonance imaging with findings of electroencephalography in patients with temporal lobe epilepsy.

INTRODUCTION: This research aimed to see how well magnetic resonance spectroscopy (MRS) could identify the lateralization side in individuals with temporal lobe epilepsy (TLE) compared to electroencephalography (EEG) and magnetic resonance imaging (MRI) results. METHODS: Twenty-three individuals were included in this research and diagnosed with TLE (both clinically and by EEG). Clinical exams, interictal EEG, and MRI were performed on all patients. In addition, the individuals were also subjected to proton MRS. RESULTS: The age range of 23 participants was 20-55 years (mean = 34.6 ± 8.5); 10 were male (44%), and 13 were female (56%). The right temporal lobe MRI showed a sensitivity and specificity of 60% and 55% for detecting mesial temporal lobe sclerosis (MTS) foci, respectively (positive predictive value (PPV) of 27% and negative predictive value (NPV) of 83%). MRI showed 83% sensitivity and 35% specificity for MTS foci in the left temporal lobe (PPV of 31% and NPV of 86%). MRS showed 61% sensitivity and 100% specificity in the right temporal lobe (PPV 100%) and 80% sensitivity and specificity in the left temporal lobe (PPV 100%) for identifying MTS foci. Overall, MRS (both left and right) results matched EEG findings. CONCLUSION: MRS is a potential noninvasive neuroradiology technique for assessing epilepsy patients because it is more sensitive than structural MRI in identifying MTS. The results of the study overall appears to be of interest but still need further support from future studies with larger sample sizes.

Evaluation of the acromion variants in MRI and their association with rotator cuff injuries in non-traumatic patients.

Purpose: Understanding demographic and MRI parameters with determinant role in rotator cuff tearing (RCT) is required to predict outcomes and select more appropriate treatment in patients with non-traumatic shoulder pain. This study aimed to survey the association of rotator cuff tears with these factors. Methods: We performed this cross-sectional study on patients referred to Kashani Hospital with non-traumatic shoulder pain suspected of rotator cuff injuries from April 2020 to February 2021. We obtained their demographic data and MRI from electronic hospital records. After that, two radiologists reviewed MRI and recorded data. We employed the SPSS 23 software to organize the obtained results and statistical evaluations. Results: 371 subjects, with the age of 48.61 ± 14.89 years, were included in our study, and 50% of them were male. The flat and down-sloping acromion and partial tearing of the supra and infraspinatus tendons were more frequent than the others. Gender could not consider as a determinant factor for the severity of tendon injuries, acromion types and variants. The relation of age to acromion morphology and the tendinopathy severity was significant. Remarkably, down-sloping acromion was higher at all the acromion shapes; however, it makes no difference in the level of supra and infraspinatus involvement. Moreover, we found that partial tearing was higher in all acromion types, except concave. This distribution was significant only for supraspinatus tears. Conclusion: The clinical decision is the most important step in patients with RCT and MRI prognostic factors, which are helpful to improve the management of the cases. RCT in older patients and down-slope acromion was more severe than the others. According to the previous studies, acromion morphology (as an important determinant factor) in RCT could be influenced by age, as well.

A rare case of hypomelanosis of Ito with enlargement of Virchow-Rabin spaces in a 10-year-old child with symptoms of seizures.

Hypomelanosis of Ito (HI) syndrome is a complex neuro-dermatological disorder that affects many organs in the body, including the skin, brain, eyes, and skeleton. This disease has been reported to present with seizures in a few rare cases. Seizures are seen in all age groups but are more common in children and the elderly. Virchow-Robin spaces (VRSs) are spaces around small arteries and the arteries that pierce the surface of the brain and are spread throughout the rest of the brain. As individuals age, the number and size of VRSs increase. A relationship between dilated VRSs and neuropsychiatric disorders has been observed above a 2 mm threshold. The patient is a 10-year-old child who was referred to the neurology ward of Imam Hossein Children's Hospital in Isfahan about 2.5 months ago due to seizures. The last seizure occurred four days before the visit, and the patient was sent for a brain computed tomography (CT) scan, which revealed diffuse bilateral hypopigmented lesions in the brain's white matter. The results of the para-clinical tests were relatively unremarkable. In the early stages of hospitalization, the child received treatment such as fluid therapy and anticonvulsant drugs to stabilize their vital condition. The patient's para-clinical tests, including brain CT, electroencephalogram, complete blood count, liver function test, and magnetic resonance imaging, showed the presence of HI syndrome and bilateral diffuse hypopigmented lesions in the white matter.

Association between patellofemoral osteoarthritis with demographic features and anatomical variants of the knee in non-traumatic patients.

BACKGROUND: Patellofemoral osteoarthritis (PFOA) is a common cause of knee discomfort and impairment, particularly among athletes. The development of PFOA has been associated with anatomical knee variations, such as trochlear dysplasia and patella alta. However, the relationship between these anatomical variants and the development of PFOA remains poorly understood. This study aimed to investigate the association between PFOA and knee anatomical variants in a cohort of patients. METHODS: The study included 200 patients with PFOA and 200 healthy controls. In this study, we investigate the relationship of osteoarthritis with both anatomical variants and demographic characteristics. The participants underwent Magnetic resonance imaging (MRI) evaluation of the knee, and anatomical variants including trochlear dysplasia and patella alta were assessed. The severity of PFOA was also graded based on cartilage area and depth, as well as the bone marrow involvement and presence of osteophytes. RESULTS: Statistically significant differences were observed between the two groups in terms of Tibial tuberosity-trochlear groove (TT-TG) distance, patella position, trochlear dysplasia, and Insall-Salvati ratio. The mean TT-TG distance, prevalence of alta patella position, and Insall-Salvati ratio were significantly higher in cases (P<0.001 for all), and cases had a higher incidence of trochlear dysplasia (P<0.001). There were no significant differences between cases and controls regarding patella baja. CONCLUSION: Anatomical knee variants, including the TT-TG distance, trochlear dysplasia, and Insall-Salvati ratio, are significant risk factors for PFOA progression. The results also indicate that higher BMI and older age are significantly associated with more measures of MRI Osteoarthritis Knee Score (MOAKS) than demographic information. Among anatomical variants, a higher TT-TG distance and an increased grade of trochlear dysplasia show a significant relationship with more measures of MOAKS. Understanding the relationship between these factors has important clinical and research implications and can help inform the development of new treatments.

Relationship between cognitive profile and neuroradiographic parameters in patients with idiopathic normal pressure hydrocephalus.

Background: Normal pressure hydrocephalus (NPH) is a reversible type of dementia, which affects 0.2 to 5.9 percent of elders. It manifests with triad of gait disturbances, urinary incontinence, and cognitive decline. In this study, association between cognitive and neuroradiographic parameters of idiopathic NPH (iNPH) was appraised to find out possible biomarkers for preventive intervention. Methods: In a cross-sectional study, 16 patients with iNPH were evaluated for third and fourth ventricle diameter, diameter of temporal horn of lateral ventricle, Evans index (EI), callosal angle (CA), callosal bowing, and ballooning of frontal horn. The Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) was used to take cognitive profile. Relation between brain magnetic resonance imaging (MRI) indices and cognitive domains was extracted, using generalized linear model (GLM). Results: Patients with mild callosal bowing had better function in memory (P = 0.050) and language (P = 0.001) than those with moderate to severe callosal bowing. Negative or mild ballooning of frontal horn was also associated with higher scores in memory (P = 0.010), executive function (EF) (P = 0.029), and language (P = 0.036) than moderate to severe ballooning of frontal horn. Increased 3rd ventricle diameter was associated with decline in total cognition (P = 0.008), memory (P = 0.019), EF (P = 0.012), and language (P = 0.001). Relation between other radiographic indices and cognitive function was not significant. Conclusion: Third ventricular diameter, rounding of frontal horn of lateral ventricle, and callosal bowing are more accurate neuroradiographic parameters to predict cognitive decline in iNPH.

Diatoms with Invaluable Applications in Nanotechnology, Biotechnology, and Biomedicine: Recent Advances.

Diatoms are unicellular microalga found in soil and almost every aquatic environment (marine and fresh water). Biogenic silica and diatoms are attractive for biotechnological and industrial applications, especially in the field of biomedicine, industrial/synthetic manufacturing processes, and biomedical/pharmaceutical sciences. Deposition of silica by diatoms allows them to create micro- or nanoscale structures which may be utilized in nanomedicine and especially in drug/gene delivery. Diatoms with their unique architectures, good thermal stability, suitable surface area, simple chemical functionalization/modification procedures, ease of genetic manipulations, optical/photonic characteristics, mechanical resistance, and eco-friendliness, can be utilized as smart delivery platforms. The micro- to nanoscale properties of the diatom frustules have garnered a great deal of attention for their application in diverse areas of nanotechnology and biotechnology, such as bioimaging/biosensing, biosensors, drug/gene delivery, photodynamic therapy, microfluidics, biophotonics, solar cells, and molecular filtrations. Additionally, the genetically engineered diatom microalgae-derived nanoporous biosilica have enabled the targeted anticancer drug delivery to neuroblastoma and B-lymphoma cells as well as the mouse xenograft model of neuroblastoma. In this perspective, current trends and recent advances related to the applications of diatoms for the synthesis of nanoparticles, gene/drug delivery, biosensing determinations, biofuel production, and remediation of heavy metals are deliberated, including the underlying significant challenges and future perspectives.

Molecularly imprinted polymers for the detection of viruses: challenges and opportunities.

Molecularly imprinted polymers (MIPs) have numerous applications in the sensing field, the detection/recognition of virus, the structure determination of proteins, drug delivery, artificial/biomimetic antibodies, drug discovery, and cell culturing. There are lots of conventional methods routinely deployed for the analysis/detection of viral infections and pathogenic viruses, namely enzyme immunoassays, immunofluorescence microscopy, polymerase chain reaction (PCR) and virus isolation. However, they typically suffer from higher costs, low selectivity/specificity, false negative/positive results, time consuming procedures, and inherent labor intensiveness. MIPs offer promising potential for viral recognition/detection with high target selectivity, sensitivity, robustness, reusability, and reproducible fabrication. In terms of virus detection, selectivity and sensitivity are critical parameters determined by the template; additionally, the analytical detection and evaluation of viruses must have considerably low detection limits. The virus-imprinted polymer-based innovative strategies with enough specificity, convenience, validity, and reusability features for the detection/recognition of a wide variety of viruses, can provide attractive capabilities for reliable screening with minimal false negative/positive results that is so crucial for the prevention and control of epidemic and pandemic viral infections. However, in the process of imprinting viruses, critical factors such as size of the target, solubility, fragility, and compositional complexity should be analytically considered and systematically evaluated. In this review, recent advancements regarding the applications of MIPs and pertinent virus imprinting techniques for the detection of viruses, as well as their current significant challenges and future perspectives, are deliberated.

Potential inhibitors of SARS-CoV-2: recent advances.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in 2019 and is the causative agent of the new pandemic viral disease COVID-19. The outbreak of COVID-19 infection is affecting the entire world, thus many researchers and scientists are desperately looking for suitable vaccines and treatment options. Indeed, researches to find potential inhibitors of SARS-CoV-2 are mainly focussed on targeting virus-host interactions or inhibiting viral assembly. Additionally, drugs and other therapeutic agents that modulate broad-spectrum host innate immune responses or interfere with signalling pathways involved in viral replication are important. These drugs may be capable of engaging host receptors or proteases utilised for viral entry or may impact the endocytosis pathway. 3CLpro (3-chymotrypsin-like protease), PLpro (papain-like protease), RdRp (RNA-dependent RNA polymerase), S protein (viral spike glycoprotein), TMPRSS2 (transmembrane protease serine 2), ACE2 (angiotensin-converting enzyme 2), and AT2 (angiotensin AT2 receptor) are important targets. With no approved therapies, this pandemic illustrates the urgent need for safe and broad-spectrum antiviral agents and strategies against SARS-CoV-2 and future pathogenic viruses. In this review, we discussed about the recent trends and important challenges regarding the potential inhibitors, antiviral drugs and nanomaterials screened against SARS-CoV-2.

A Multicenter Survey on the Trend of Chest CT Scan Utilization: Tracing the First Footsteps of COVID-19 in Iran.

BACKGROUND: Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran. OBJECTIVES: To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments. Methods: In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018-2019. RESULTS: A 50.2% increase was noted in the chest CT scan utilization in 2019-2020 compared to 2018-2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1-5 of 2019-2020, respectively. In Month 6 of 2019-2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018-2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018-19. CONCLUSION: The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

Periosteal chondroma of pelvis - an unusual location.

Periosteal chondroma is a slow growing benign tumor with prevalence rate of less than 2% of all chondromas. This tumor is mostly observed in clavicle, ribs and humerus and only one previous case has been reported in pelvis. Here we present an unusual case of periosteal chondroma due to uncommon presentation, location and age range. Our case is a 39 year-old male diagnosed with periosteal chondroma in pelvis. He had unspecific signs and symptoms overlapping with low back pain and disk herniation. By the time of admission he had gluteal muscle atrophy and also claudication. Differentiation of periosteal chondroma from other malignant tumors are pivotal in order to prevent aggressive and inappropriate therapies. He underwent surgical procedures and periosteal chondroma was ascertained by both radiological and Histopathological evidence. 6 months after surgery, he declared no pain, he was able to walk freely. He claimed partial paresthesia but he also declared that his paresthesia has ameliorated.

Deep-COVID: Predicting COVID-19 from chest X-ray images using deep transfer learning.

The COVID-19 pandemic is causing a major outbreak in more than 150 countries around the world, having a severe impact on the health and life of many people globally. One of the crucial step in fighting COVID-19 is the ability to detect the infected patients early enough, and put them under special care. Detecting this disease from radiography and radiology images is perhaps one of the fastest ways to diagnose the patients. Some of the early studies showed specific abnormalities in the chest radiograms of patients infected with COVID-19. Inspired by earlier works, we study the application of deep learning models to detect COVID-19 patients from their chest radiography images. We first prepare a dataset of 5000 Chest X-rays from the publicly available datasets. Images exhibiting COVID-19 disease presence were identified by board-certified radiologist. Transfer learning on a subset of 2000 radiograms was used to train four popular convolutional neural networks, including ResNet18, ResNet50, SqueezeNet, and DenseNet-121, to identify COVID-19 disease in the analyzed chest X-ray images. We evaluated these models on the remaining 3000 images, and most of these networks achieved a sensitivity rate of 98% ( ±  3%), while having a specificity rate of around 90%. Besides sensitivity and specificity rates, we also present the receiver operating characteristic (ROC) curve, precision-recall curve, average prediction, and confusion matrix of each model. We also used a technique to generate heatmaps of lung regions potentially infected by COVID-19 and show that the generated heatmaps contain most of the infected areas annotated by our board certified radiologist. While the achieved performance is very encouraging, further analysis is required on a larger set of COVID-19 images, to have a more reliable estimation of accuracy rates. The dataset, model implementations (in PyTorch), and evaluations, are all made publicly available for research community at https://github.com/shervinmin/DeepCovid.git.