The Significance of Hounsfield Unit and Tumor Diameter in the Differentiation of Malignant and Benign Adrenal Masses

Aim: The Hounsfield unit (HU) used in non-contrast computed tomography (CT) imaging can predict adrenal masses. In the literature, a HU measurement of >10 on non-contrast CT has been reported to have a wide range of sensitivity (33-72%) in detecting malignancy in patients with adrenal masses, and the size of malignant masses is >4 cm in approximately 90% of cases. The current study investigated the role of the HU value and tumor diameter measured on preoperative CT imaging in the differentiation of benign and malignant masses. Methods: Data analysis was conducted on patients undergoing adrenalectomy for adrenal masses at two different tertiary care centers between January 1, 2019 and January 1, 2023. Patients who underwent an adrenalectomy non-contrast CT scans were assessed for HU and tumor size. The patients were divided into two groups according to histopathologically confirmed benign or malignant masses. Statistical analysis, including receiver operating characteristic curve assessment, was performed to evaluate the diagnostic accuracy. Results: The study included 108 patients, of whom 66.7% (n=72) were female and 33.3% (n=36) were male. The mean age was 51.01±14.01 years. The laparoscopic technique was used in 72 patients, the robotic technique in 17, and the open technique in 19. The mean length of hospital stay was 4 (2-37) days. The mean tumor size was 55 (10-230) mm. The mean operative time was 80 (50-180) minutes. The mean amount of intraoperative blood loss was 40 (20-300) milliliters. The surgical method, tumor diameter, operative time, amount of intraoperative blood loss, and HU value of the mass statistically significantly differed between the groups (p<0.001). We found that the cut-off values of HU and tumor diameter for distinguishing malignant masses from benign masses were 30.5 and 72.5 mm, respectively. At a cut-off value of 30.5 or above, HU had a sensitivity of 100% and a specificity of 81.6% in identifying malignant masses, whereas a sensitivity of 100% and a specificity of 88.7% were determined for malignant masses with a tumor size of 72.5 mm or above. Conclusion: The HU value and tumor diameter were crucial for distinguishing between benign and malignant adrenal masses, enhancing diagnostic accuracy, and informing treatment decisions

Successful Treatment of Uterine Arteriovenous Malformation due to Uterine Trauma

Uterine arteriovenous malformation (AVM) is defined as abnormal and nonfunctional connections between the uterine arteries and veins. Although the patients typically present with vaginal bleeding, some patients may experience life-threatening massive bleeding in some circumstances. The treatment of choice depends on the symptoms, age, desire for future fertility, and localization and size of the lesion; however, embolization of the uterine artery is the first choice in symptomatic AVM in patients at reproductive age with expectations of future fertility. We report a case of acquired AVM (after D/C) with an extensive lesion, which was successfully treated with bilateral uterine artery embolization (UAE)

Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey

WOS: 000468584300005PubMed ID: 30930455Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.Turkish Society of CardiologyThis study was supported by Turkish Society of Cardiology

Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey

Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50\%). Results: A total of 1098 patients (male, 47.5\%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 \%; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8\% for patients who were >= 80 years and 27.1\% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67\% for hypertension (HT), 25.6\% for diabetes mellitus (DM), 54.3\% for coronary artery disease (CAD), and 42.3\% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65-79 years, 43.9\% (548) had HFpEF, and 56.1\% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged >= 80 years with HFrEF (p<0.01). Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF