Role of Diffusion Weighted Magnetic Resonance Imaging in evaluation of hepatic focal lesions

Objective: To clarify role of Diffusion Weighted Magnetic Resonance Imaging (DW MRI) in the detection of hepatic focal lesions and its ability to differentiate benign from malignant hepatic focal lesions. Patients and methods: This study included 40 patients who were referred to our institution from the different medical and surgical departments as well as oncology unit. Patients with chronic renal impairment or previous allergy to the contrast media were excluded from the study. All patients were subjected to careful history taking, general and abdominal examination, laboratory examinations, and liver MRI. Results: The lowest ADCs were found in metastases, CCA and HCCs and the highest values were found in hemangiomas. The difference between the mean ADC values of benign and malignant lesions was significant. No significant differences in ADC values among the different benign lesions or among the different malignant lesions at both sequences. Conclusion: In conclusion, DW MRI alone performs equally well as Gd-MRI in detection and differentiation of different hepatic focal lesions. In cases where gadolinium injection is not allowed, dynamic contrast-enhanced imaging can be replaced by a protocol based on unenhanced T1 and T2 weighted imaging combined with DWI. Adding DWI to Gd-MRI is more accurate

Role of MRI in differentiating benign from malignant breast lesions using dynamic contrast enhanced MRI and diffusion weighted MRI

Objective: To evaluate the role of MRI in differentiation of benign from malignant breast lesions using dynamic contrast enhanced MRI (DCE-MRI) and diffusion weighted MRI (DW-MRI). Patients and methods: The study included 33 female patients with clinically suspicious breast lesions detected by mammography and/or breast ultrasound. Cases were referred from general surgery departments in Tanta university hospital. The patients underwent full history taking and clinical examination, full field digital mammography and US, for those patients cases diagnosed on sonomammography as BI-RADS 3 & 4 were selected for MRI examination. Results: Quantitative analysis of DWI was done for the 33 breast lesions and their ADC values are recorded at 3 different b-values (250, 600, and 1000). Seventeen lesions showed facilitated diffusion, proved to be benign and 10 lesions showed restricted diffusion, 9 lesions of them proved to be malignant and one proved to be benign. There are 6 lesions showed mixed restricted and facilitated diffusion proved to be malignant. Conclusion: DWI improves the diagnostic ability of the DCE-MRI of the breast. It is a better method for detecting breast lesions than either T1- or T2-weighted imaging, but it is better to be performed in conjunction with contrast enhanced MRI

Low dose aspirin versus low dose aspirin plus omega 3 versus low molecular weight heparin in treatment of unexplained recurrent miscarriage

Introduction: recurrent miscarriages are the loss of 3 or more consecutive pregnancies before the 20th week of gestation. It is classified into primary and secondary. Objective: to evaluate the effectiveness of low dose aspirin vs. low dose aspirin and omega 3 vs. LMWH in treatment of unexplained recurrent miscarriage. Materials and methods: This comparative prospective research was conducted on 60 1st trimester pregnant female with a history of two or more unexplained spontaneous consecutive abortion aged from 18 to 36 years old with gestational age (5-7 weeks) and single intrauterine pregnancy. Patients were subdivided equally into 3 groups: Group A: received a daily dose of 75mg of aspirin, group B: received a daily dose of 75 mg of aspirin in addition to 300mg of omega -3 fatty acids and group C: received a daily dose of 4000 IU of enoxaparin. Results: There was an insignificant difference in pregnancy outcome among the three groups. 12 (60%) cases in group A, 15 (75%) cases in group B and 14 cases in group C completed 20 weeks of pregnancy

RETRACTED: Multi-detector computed

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor. The authors have plagiarized part of a paper that had already appeared in EJRNM, 44 (2013) 697–704. doi:10.1016/j.ejrnm.2013.07.005. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process

Psychiatric and sleep abnormalities in school-age children with migraine

Abstract Background Migraine is a primary headache that commonly starts in childhood and adolescent’s periods with great negative impacts on the educational and psychosocial performances of its sufferers. The objectives of this work were to study the existence and types of sleep and psychiatric abnormalities in school-age children with migraine (SCM). Methods The study was conducted on 40 SCM and 20 age- and sex-matched healthy control subjects (HCS) submitted to history taking, neurological examination, Pediatric Migraine Disability Assessment (PedMIDAS) questionnaire, Child Behavior Checklist (CBCL), Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), Pittsburgh Sleep Quality Index (PSQI) and one-night polysomnography (PSG). Results The study showed a high incidence of psychiatric and sleep abnormalities in SCM. The most common psychiatric disorders were anxious depressed symptoms, withdrawal depressed symptoms, social problem, somatic complaints, and attention problems. At the same time, SCM experienced decreased sleep quality, excessive daytime sleepiness (EDS), and PSG abnormalities in the form of decreased total sleep time (TST) and sleep efficiency (SE) in addition to increased sleep latency, wake after sleep onset (WASO), arousal index (AI), and REM sleep without atonia index. Conclusion Sleep and psychiatric abnormalities are common underdiagnosed pediatric migraine comorbidities greatly reducing headache control and school performance in this very important period of psychosocial development

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

ObjectiveTo document the recovery of vascular services in Europe following the first COVID-19 pandemic peak.MethodsAn online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume.ResultsThe impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence.ConclusionCentres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries

Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries