Evaluation of the value of chest CT severity score in assessment of COVID-19 severity and short-term prognosis.

Background: Evaluations have shown that the severity of pulmonary involvement is very important in the mortality rate of patients with coronavirus disease 2019 (COVID-19). The purpose of this study was to evaluate the value of chest CT severity score in assessment of COVID-19 severity and short-term prognosis. Materials and Methods: This study was a cross-sectional study with a sample size of 197 patients, including all patients admitted to Rasoul Akram Hospital, with positive polymerase chain reaction, to investigate the relationship between computed tomography (CT) severity score and mortality. The demographic data and CT scan findings (including the pattern, side, and distribution of involvement), co-morbidities, and lab data were collected. Finally, gathered data were analyzed by SPSS-26. Results: 119 (60.4%) patients were male, and 78 (39.6%) were female. The mean age was 58.58 ± 17.3 years. Totally, 61 patients died; of those, 41 (67.2%) were admitted to the intensive care unit (ICU), so there was a significant relation between death and ICU admission (P value = 0.000). Diabetes was the most common co-morbidity, followed by hypertension and IHD. There was no significant relation between co-morbidities and death (P value = 0.13). The most common patterns of CTs were interlobular septal thickening and ground glass opacities, and a higher CT severity score was in the second week from the onset of symptoms, which was associated with more mortality (P value < 0.05). Conclusion: Our study showed that a patient with a higher CT severity score of the second week had a higher risk of mortality. Also, association of the CT severity score, laboratory data, and symptoms could be applicable in predicting the patient's condition.

Determining the relative frequency of ultrasound findings in women under 30 years of age with a breast mass.

Introduction: Mammography and ultrasound are the most reliable and common imaging techniques for early detection of breast mass. The aim of this study was to determine the relative frequency of ultrasound findings in women under 30 years of age by a feeling of mass in the breast. Methods: This cross-sectional study was performed on women under 30 years of age with a feeling of mass in the breast. The result evaluated in this study was the final opinion of the radiologist on the ultrasound report, which was expressed in the form of Breast imaging-reporting and data system (BIRADS) based on one to five scores. Ultrasound status of patients was reported to be normal, fibrocystic changes, and tumors (solid-cystic-mixed). The obtained data were analyzed using SPSS statistical software version 23. Significance level was considered to be < 0.05. Results: The most common reason for referral was palpable mass in the left breast (56.2%). The shape of the mass was oval in most cases (91.2%). The highest frequency in terms of mass margin was related to Macrolobulated (82.4%), Hypoechoic (85%), and Solid (87.6%). Most of masses belonged to 12 o'clock (21.2%). According to the standard sonography report based on BIRADS, the highest frequency belonged to B4a (57.5%). Pathology report showed that the highest frequency was related to fibroadenoma (71.4%). Conclusion: Considering that most of the cases in this research with a feeling of mass in the breast in women under 30 years of age were BIRADS 4, and among the cases that underwent biopsy, 14.5% were diagnosed with cancer pathology. Therefore, ultrasound examination is very important in these cases, even at a young age.

Efficacy of diffusion-weighted imaging in symptomatic and asymptomatic multiple sclerotic plaques.

INTRODUCTION: Magnetic resonance imaging (MRI) currently accompanies clinical findings in disease diagnosis, patients' follow-up, assessment of drugs complications, and evaluation of treatment response. Although contrast-enhanced MRI (CE-MRI) is considered as the imaging modality of choice for multiple sclerosis (MS), due to disease chronicity, applying multiple doses of gadolinium-based contrast agents (GBCAs) increases the risk of nephrogenic syndrome in patients with acute (ARF) and chronic renal syndromes (CRF). Moreover, the effect of gadolinium on the fetus is not well-known in pregnant patients. Therefore, this study evaluates the possibility of replacing postcontrast images with physiologically based MRI sequences such as diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC). METHOD: We prospectively evaluated 26 patients with known multiple sclerosis. The patients with MS attacks and the asymptomatic patients who were referred for follow-up were enrolled. Conventional MRI including postcontrast T1W, DWI, and ADC were performed for all patients. The signal intensity (SI) of all enhancing and nonenhancing plaques of more than 10 × 10 mm size were investigated in all sequences and analyzed. RESULTS: A total of 83 plaques were detected in T2-FLAIR sequences of which 51 plaques were enhanced (68%) after gadolinium administration. While 42 MS plaques had hypersignal intensity in DWI (56%), 32 plaques had iso- or hyposignal intensities in DWI (44%). No statistically significant values were obtained. CONCLUSION: Although DWI could not replace CE-MRI, using these two modalities together could increase detection of active MS plaques and alter patients' therapy and prognosis.

Investigation into breast cancer and partial breast reconstruction: A review.

Growing increasingly in South America, Africa and Asia, breast cancer is known as the dominant type of cancer in women. Different treatments are available for breast cancer, among which surgery is the most widely used, but researchers are trying to develop new strategies. One of the most prominent surgical methods is referred to as oncoplastic surgery, that helps to remove segments of malignant breast tissue. This type of surgery aims to obtain vast surgical margins, while the remaining tissue is rearranged so that the better cosmetic outcome is obtained. This review will investigate the breast cancer and then discuss partial breast reconstruction. Before outlining the procedures, the different types of partial breast reconstruction will be discussed. Finally, advantages and disadvantages will be outlined. MEDLINE database was used to conduct the search. The main terms used were 'Conservation Breast Surgery Reconstruction' AND 'Oncoplastic Surgery', 'Partial Mastectomy Reconstruction' AND 'Conservative Breast Surgery Reconstruction', 'oncoplastic' [All Fields], 'breast' AND 'surgery' OR 'surgery' operative', 'oncoplastic' ('breast')'. The bibliographies of relevant papers were manually searched up to October 2018, but more recent voices are also included.

Application of Imaging Technologies in Breast Cancer Detection: A Review Article.

One of the techniques utilised in the management of cancer in all stages is multiple biomedical imaging. Imaging as an important part of cancer clinical protocols can provide a variety of information about morphology, structure, metabolism and functions. Application of imaging technics together with other investigative apparatus including in fluids analysis and vitro tissue would help clinical decision-making. Mixed imaging techniques can provide supplementary information used to improve staging and therapy planning. Imaging aimed to find minimally invasive therapy to make better results and reduce side effects. Probably, the most important factor in reducing mortality of certain cancers is an early diagnosis of cancer via screening based on imaging. The most common cancer in women is breast cancer. It is considered as the second major cause of cancer deaths in females, and therefore it remained as an important medical and socio-economic issue. Medical imaging has always formed part of breast cancer care and has used in all phases of cancer management from detection and staging to therapy monitoring and post-therapeutic follow-up. An essential action to be performed in the preoperative staging of breast cancer based on breast imaging. The general term of breast imaging refers to breast sonography, mammography, and magnetic resonance tomography (MRT) of the breast (magnetic resonance mammography, MRM). Further development in technology will lead to increase imaging speed to meet physiological processes requirements. One of the issues in the diagnosis of breast cancer is sensitivity limitation. To overcome this limitation, complementary imaging examinations are utilised that traditionally includes screening ultrasound, and combined mammography and ultrasound. Development in targeted imaging and therapeutic agents calls for close cooperation among academic environment and industries such as biotechnological, IT and pharmaceutical industries.

Recent advances of therapeutic targets based on the molecular signature in breast cancer: genetic mutations and implications for current treatment paradigms.

Breast cancer is the most common malignancy in women all over the world. Genetic background of women contributes to her risk of having breast cancer. Certain inherited DNA mutations can dramatically increase the risk of developing certain cancers and are responsible for many of the cancers that run in some families. Regarding the widespread multigene panels, whole exome sequencing is capable of providing the evaluation of genetic function mutations for development novel strategy in clinical trials. Targeting the mutant proteins involved in breast cancer can be an effective therapeutic approach for developing novel drugs. This systematic review discusses gene mutations linked to breast cancer, focusing on signaling pathways that are being targeted with investigational therapeutic strategies, where clinical trials could be potentially initiated in the future are being highlighted.

Comparison of uterine and ovarian stromal blood flow in patients with polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders. The aim of this study was to find the correlation between color Doppler ultrasound and serum tests as auxiliary diagnostic criteria in areas where there is no possibility of some tests. A total of 108 patients were enrolled. They were divided into three groups including patients with PCOS, patients with PCOA ultrasound, patients with ovaries and normal hormone tests. Transvaginal sonography was performed from three groups and the results were evaluated in gray scale. The volume of the ovary, the number of follicles and the placement of follicles were recorded using using Doppler spectrum of uterine artery and ovarian stroma. Their arterial resistance index was also calculated. In the next step, serum samples were evaluated to determine the level of LH, FSH, free testosterone, DHEAS and 17-OHP hormones in the early follicular phase. Gray scale ultrasonographic findings (volume and number of ovarian follicles) as well as LH values were higher in patients with PCOS than those in the other two groups. These results proved the reliability of using these factors in the prediction of PCOS. In this study, Doppler indexes did not correlate with the size of the ovaries, the number of ovarian follicles and the measured hormone levels. The findings of transvaginal ultrasound and investigating the relationship with clinical and laboratory outcomes, a more suitable pattern could be chosen for more accurate patient selection and, leading to timely treatment and reducing the complications of the disease.

Antenatal umbilical coiling index in gestational diabetes mellitus and non-gestational diabetes pregnancy.

OBJECTIVE: Umbilical cord abnormalities increase fetal morbidity and mortality. This study was designed to compare antenatal umbilical coiling index (aUCI) in gestational diabetes mellitus (GDM) and non-gestational diabetes mellitus (non-GDM) pregnancy, considering uncertainties about the best time to perform antenatal ultrasonography scan. MATERIALS AND METHODS: In this prospective study, 246 parturients were included, 123 with GDM and 123 with non-GDM pregnancy. Gestational diabetes was confirmed at 24-28 weeks of gestation (WG) using one-step strategy. An anatomical ultrasound survey of placenta and umbilical cord was performed at 18-23 as well as 37-41 weeks of gestational age. RESULTS: At 18-23 WG, the frequency distribution (10th, 90th percentiles, mean ± SD) of the aUCI in the GDM and non-GDM groups were (0.13,0.66,0.32 ± 0.19) and (0.18,0.74, 0.4 ± 0.31) respectively. These values were (0.12,0.4, 0.25 ± 0.11) in the GDM group at 37-41 WG and (0.17,0.43, 0.29 ± 0.11) in the non-GDM group. A significant relationship was detected between UCI value and GDM/non-GDM groups at both antenatal evaluations (18-23 WG; P = 0.002, 37-41WG; P < 0.001). A significant association at 18-23 WG was found between GDM/non-GDM groups and aUCI categorization (hypocoiling <10th, normocoiling 10th-90th and hypercoiling >90th) (P = 0.001). However, hypocoiling were significantly more frequent in GDM than non-GDM in both antenatal evaluations (P < 0.001, P = 0.006). CONCLUSION: Antenatal UCI in pregnancy complicated by GDM were lower in comparison with non-GDM pregnancy. The most abnormal pattern of coiling in gestational diabetes was hypocoiling in both trimesters. In addition, 18-23 WG is the best time to perform ultrasound scan to detect aUCI and umbilical cord pattern.

Ultrasound screening at 11-14 weeks of pregnancy for diagnosis of placenta accreta in mothers with a history of cesarean section.

The aim of this study was to add ultrasonographic screening criteria for placenta accreta in patients with cesarean section history at 11-14 weeks of gestation in order to identify those with the high risk of placenta accreta. Consequently, using ultrasound follow-up and confirmation of diagnosis can reduce mortality and morbidity. Pregnant mothers who were referred for routine screening for ultrasonography at 11-14 weeks of gestation were enrolled in the study if they had a history of cesarean section. Of the 184 subjects who were included in the study, 23 of the low-risk groups were excluded from study for some reason such as miscarriage and a lack of required information on the time of delivery. Among the 152 subjects, 27 were classified in the high-risk group (17.7%) and 125 subjects in the low-risk group (82.3%). Only one case in the high risk group was identified in patients with placenta accreta by ultrasound and clinical diagnosis, which has undergone a cesarean section at the gestational age of 35 weeks. There was no relationship between placenta accreta and disease risk, placenta previa, cesarean section, maternal age, and gravidity. Therefore, placenta accreta screening using ultrasonography can identify high-risk individuals at week 14-11 and with subsequent follow-up for improving prenatal prognosis..

Color Doppler sonography of the aortic isthmus in intrauterine growth-restricted fetuses and normal fetuses.

Intrauterine growth restriction is associated with a significant increase in morbidity and perinatal mortality, and increases the likelihood of fetal death, asphyxia, meconium aspiration, hypoglycemia, and neonatal hypothermia. The aim of this study was to determine aortic isthmus flow difference by using color doppler sonography in Intrauterine growth restriction and normal fetuses. The data presented were obtained from 30 mothers, who referred to the radiology department of Akbarabadi Hospital of Tehran with a diagnosis of intrauterine growth restriction. An ultrasound was performed to determine the status of placenta, fetus, and amniotic fluid. The umbilical arterial doppler assessment was used to confirm diagnosis of intrauterine growth restriction. Thirteen (43.3%) were nulliparous mothers and 17 (56.7%) were multiparous mothers. 30 pregnant women with healthy fetuses were enrolled as control group. According to the ultrasound findings, Dactus Venus wave type was recorded in intrauterine growth restriction fetuses, which was reported as normal (26 subjects; 86.7%) and abnormal (4 subjects; 13.3%). All together, this study provides appropriate guidance to use doppler for delivery timing and to control risk factors.

Chorionic Bump in First-trimester Sonography.

OBJECTIVES: The present research was motivated by providing new insight into early pregnancies with a chorionic bump diagnosis in first-trimester sonography and its impact on live birth rate. METHODS: To determine the rate of CB, first trimester sonograms of pregnant women referring to Akbarabadi Hospital, which is a treatment and training center affiliated to Iran University of Medical Sciences as well as those referring to a private center were analyzed. The total number of transvaginal sonographies performed was 1900 cases from whom 8 cases of CB were detected. The chorionic bump size and number and history of infertility or coagulation disorders were considered as our independent variables and multiple gestation with pregnancy outcome as dependent ones. RESULTS: Overall, the prevalence rate of CB was 0.4% (4 per 1000), with 8 patients diagnosed with CB from 1900 the first trimester pregnant women. Of 8 pregnant women, 5 showed live birth (62.5%) and 3 experienced fetal demise (37.5%). The chorionic bumps ranged in size from 0.1 cc to 1.8 cc (average, 0.73 cc). No significant relationship was found between history of smoking, coagulopathy, infertility, multiple gestation and the size of CB. CONCLUSIONS: The main finding was that the frequency of live birth in our sample was 62.5% (5 from 8). The clinical inference is that a chorionic bump on first-trimester sonography does not definitely guarantee a secure prediction. The correlation between bump size and pregnancy outcome is not clear, which warrants further research.