The Results of Abdominopelvic Computed Tomography Interpreted via Remote Access for the Diagnosis of Acute Appendicitis

Introduction: Abdominal computed tomography (CT) is one of the imaging modalities for the diagnosis of acute appendicitis (AA). Today, CT scans can be interpreted via remote access called tele-radiology, besides conventional methods. The objective of this study was to evaluate the CT interpreted via tele-radiology for diagnosing AA. Methods: In this retrospective study, a total of 679 patients, who were interpreted via tele-radiology of CT due to suspicion of AA, were evaluated. Age, gender, CT findings, pathology results and intra-operative diagnosis of those with normal CT results were analysed. A sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of CT in the diagnosis of AA were calculated. Results: 520 patients who were operated with pre-diagnosed AA were found. Of those, 441 patients (84.8%) were diagnosed with AA according to CT reports, out of which 368 (83.4%) were positive (true-positive) and 73 (16.6%) were negative (false-positive) in terms of pathology results. In the remaining operated 79 patients with normal CT results, 58 (73.4%) were positive for AA and 21 (26.6%) (negative laparotomy) were negative for AA in terms of pathological examination. The sensitivity, specificity, accuracy, PPV and NPV of CT in the diagnosis of AA were determined as 81.2%, 67.7%, 76.7%, 83.4% and 64.2%, respectively. Conclusion: The sensitivity and PPV rates were found similar in both conventional and tele-radiological methods. However, specificity, accuracy and NPV rates were determined lower than in literature. Additionally, the negative laparotomy rate was higher than the conventional method

Tedaviden sonra tanı konan karaciğer fascioliasis olgusu

İstanbul University, Cerrahpaşa Medical Faculty, Department of Internal Medicine, Division of HematologyOrdu State Hospital, Department of Internal Medicine, Division of Gastroenterologyİstanbul University, Medical Faculty of İstanbul University, Department of Radiologyİstanbul University, Medical Faculty of İstanbul University, Department of Internal MedicineHuman fascioliasis is a rare parasitic disease caused by Fasciola hepatica, affecting mainly the liver and the biliary tract. If not suspected, it may easily be confused with other pathologies that will lead to incorrect diagnosis as well as inappropriate treatments. Late diagnosis of the hepatic fascioliasis may cause irreversible liver damage and insufficiency. In this case report, we present the computed tomography and magnetic resonance imaging findings of a hepatic fascioliasis case that was diagnosed after the treatmentİnsan fasioliyazisi, başlıca karaciğer ve safra yollarını etkileyen, Fasciola hepatica’nın neden olduğu nadir bir paraziter hastalıktır. Şüphelenilmezse yanlış tanıya ve uygunsuz tedavilere neden olacak diğer patolojilerle kolayca karıştırılabilir. Tanısı geç konulan karaciğer fascioliasis, geri dönüşü olmayan karaciğer hasarına ve yetmezliğine neden olabilir. Bu yazıda, tedaviden sonra tanı konulan bir karaciğer fascioliasis olgusunun bilgisayarlı tomografisi ve manyetik rezonans görüntüleme bulguları sunulmuştu

Leptin as an important link between obesity and cardiovascular risk factors in men with acute myocardial infarction

Objective: The levels of leptin, a major regulator of lipid metabolism, may increase in obesity, and contribute to the development of metabolic syndrome. Leptin is produced by adipose tissue and is a peptide hormone, which has strong association with obesity, elevated cardiovascular risk, and morbidity. The present study was designed to evaluate the relationships between leptin levels, obesity, and cardiovascular risk factors in men with acute myocardial infarction. Methods and results: Twenty-four obese and twenty-three nonobese male patients, who had experienced their first myocardial infarction, were included in the study. Their leptin levels, biochemical parameters, and anthropometric measures were obtained. Mean leptin levels were significantly higher in the obese group compared to the nonobese group (2.53 ng/mL versus 1.23 ng/mL; p < 0.01). Leptin levels correlated positively with anthropometric measurements, triglyceride, fasting glucose, C-reactive protein, and uric acid levels, and negatively with high-density lipoprotein cholesterol levels. Conclusion: Findings indicate high leptin levels to be positively correlated with obesity and diastolic blood pressure in male patients with myocardial infarction

A rare upper gastrointestinal bleeding cause: Dieulafoy lesion

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Gastrointestinal sistemin nadir görülen kanama nedenlerinden biri Dieulafoy lezyonudur. Bu lezyonlar yaşamı tehdit edecek masif kanamalara yol açabilir. Tanı ve tedavide rutin olarak endoskopi kullanılmaktadır. Bu vasküler anomali genellikle midenin proksimalinde görülmekle beraber özofagus, ince ve kalın bağırsakta da görülebilir. Dieulafoy lezyonu sıklıkla lümene çıkıntılı, yeni olgularda üzerinde pıhtı bulunan arteriyel damar lezyonudur. Tedavide öncelikle endoskopik girişimler uygulanmalı, sonuç alınamıyorsa hasta ameliyat edilmelidir. Bu makalede Dieulafoy lezyonunun yol açtığı masif üst gastrointestinal sistem kanamasından dolayı acil ameliyat edilen 25 yaşında bir erkek olgu sunuldu.One of the rare cause of upper gastrointestinal tract bleeding is Dieulafoy lesion. These lesions may lead life threatening massive bleeding. Endoscopy is used for diagnose and treatment in routine basis. Although this vascular anomaly is generally seen on the proximal part of stomach, it can seen on esophagus, small bowel and colon, as well. Dieulafoy lesion is generally protrusive vascular lesion on the mucosal surface of the stomach. This lesion has a clot on it, in novel cases. In the treatment endoscopic procedures should be applied at first-line, if it doesn’t work, the patient must undergo for a surgery. Herein, a 25-year-old male patient with Dieulafoy lesion has reported, caused massive upper gastrointestinal bleeding, which underwent surgery

PET/CT Positivity Has Lower Survival in Adult Living Donor Liver Transplantation for Hepatocellular Carcinoma

65th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases -- NOV 07-11, 2014 -- Boston, MAWOS: 000344483802145…Amer Assoc Study Liver Di