Diffusion Weighted Magnetic Resonance Imaging for the Characterization of Solitary Pulmonary Lesions

Background: We evaluated the differential diagnosis of solitary pulmonary lesions on magnetic resonance imaging.Aims: To investigate the value of diffusion weighted imaging on the differential diagnosis of solitary pul-monary lesions.Study Design: Randomized prospective study.Methods: This prospective study included 48 solitary pulmonary nodules and masses (18 benign, 30 ma-lignant). Single shot echo planar spin echo diffusion weighted imaging (DWI) was performed with two b factors (0 and 1000 s/mm2). Apparent diffusion coeffi-cients (ADCs) were calculated. On diffusion weighted (DW) trace images, the signal intensities (SI) of the le-sions were visually compared to the SI of the thoracic spinal cord using a 5-point scale: 1: hypointense, 2: moderately hypointense, 3: isointense, 4: moderately hyperintense, 5: significantly hyperintense. For the quantitative evaluation, the lesion to thoracic spinal signal intensity ratios and the ADCs of the lesions were compared between groups.Results: On visual evaluation, taking the density of the spinal cord as a reference, most benign lesions were found to be hypointense, while most of the malignant lesions were evaluated as hyperintense on DWI with a b factor of 1000 s/mm2. In contrast, on T2 weighted images, it was seen that the distinction of malignant lesions from benign lesions was not statistically significant. The ADCs of the malignant lesions were significantly lower than those of benign lesions (mean ADC was 2.02×10-3 mm2/s for malignant lesions, and 1.195×10-3±0.3 mm2/s for benign lesions). Setting the cut-off value at 1.5×10-3, ADC had a sensitivity of 86.7% and a specificity of 88.9% for the differentiation of benign lesions from malignant lesions.Conclusion: DWI may aid in the differential diagnosis of solitary pulmonary lesions. (ClinicalTrials.gov Iden-tifier: NCT02482181

Evaluation of Agreement Between Sweep Visual Evoked Potential Testing and Subjective Visual Acuity

Objectives:The primary objective of this study was to evaluate the agreement of visual acuity (VA) obtained with the sweep visual evoked potential (sVEP) method with the VA obtained with the Snellen chart. The secondary objective was to examine the effect of age and gender on agreement.Materials and Methods:Best corrected VAs of subjects were recorded with the Snellen chart, and sVEP testing was performed according to the recommendations of the International Society for Clinical Electrophysiology of Vision (ISCEV). Snellen VAs and sVEP measurements were analyzed using logMAR conversion for statistical analysis. Agreement was evaluated with Bland-Altman analysis.Results:The study included 49 subjects with a mean age of 53.5±17.3 years (range: 19-75 years) and mean Snellen VA of 0.31±0.32 logMAR (range: 1.3-0.0 logMAR). In the Bland-Altman analysis, the mean differences between the VA and sVEP measurements (VA-sVEP) were significantly different and outside the limits of agreement (p=0.035). A significant proportional bias (p=0.0007) was found in the regression analysis performed between VA-sVEP and the mean VA. According to the Bland-Altman analysis of sex subgroups, there was a significant difference between VA and sVEP measurements in female subjects (p=0.006). The difference between VA and sVEP measurement increased significantly with older age (R2: 0.306, p<0.001, β: 0.05 [0.03, 0.08]).Conclusion:In conclusion, sVEP measurements and VAs did not show statistical agreement. Cranial anatomy and endocrine differences of the subjects may affect their sVEP measurements. The difference between the methods varies according to VA level. Directly using sVEP results instead of VA would not be appropriate

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

ALTMETRIC ANALYSIS OF THE MOST-CITED 100 ARTICLES ON THE RETINA PUBLISHED BETWEEN 2010 AND 2020.

Purpose: Altmetric analysis is a way of assessing the social impact of scientific articles. In this study, we aimed to analyze the 100 most-cited articles on the topic of the retina published in ophthalmology journals in traditional metrics and altmetrics. Methods: The term "retina" was searched in the Web of Science database, and articles published in ophthalmology journals were filtered out. A total of 100 highly cited articles from 2010 to 2020 were evaluated for bibliographic data and altmetrics. First, descriptive statistics and then correlation analysis between traditional bibliographies and altmetrics were performed. Results: According to the Web of Science search, the number of citations of the articles listed in the top 100 list ranged from 809 to 137. The altmetric scores of the articles listed in the top 100 list ranged from 0 to 1,340. There was no statistically significant correlation between the altmetric scores and the number of citations, but there was a statistically weak correlation between the altmetric scores and the average citations per year, H index, impact factor, and number of years since publication. Conclusion: Altmetrics is not sufficient to determine the scientific value of articles and can be affected by many factors, unlike traditional bibliometrics. However, being a good communicator in social media can support scientific productivity and create social impact

Göz ve Orbita Yapılarının Konjenital Anomalileri

Göz küresi ve içinde yerleştiği orbita ve eklerinin konjenital anomalileri nadir olmayarak görülen bozukluklardır. İzole bir sporadik anomali olarak veya bir sendromun parçası olarak görülebilirler. Vücudun diğer organ ve doku anomalilerinde olduğu gibi genel teratojenik etkenler burada da söz konusudur. Herediter özellikler büyük oranda etkilidirler. Anomaliye yol açan faktörün etki etmeye başladığı intrauterin döneme bağlı olarak anomalinin ağırlığı değişir. Patolojik tablo tek ya da iki taraflı, simetrik ya da asimetrik olabilir

Fakik Bir Pediatrik Gözde Minimal İnvaziv Cerrahi ile Travmatik İridodiyaliz Tamir Tekniği

Bu çalışmanın amacı, sol gözüne aldığı ciddi bir künt travma sonrası yaklaşık 120 derecelik iridodiyaliz, polikori ve ekzantrik pupilla, görme aksı kapanması ve korneada çok sayıda yabancı cisimle polikliniğimize başvuran sekiz yaşındaki fakik bir olguda, minimal invaziv teknikle yapılan iridodiyaliz tamir yöntemini tanımlamak ve yaklaşımımızı tariflemektir

Bilateral cystoid macular edema in a patient treated with capecitabine Kapesitabin ile Tedavi Edilen Bir Hastada Bilateral Kistoid Makula Ödemi

© 2019 Gazi Eye Foundation. All rights reserved.A 76-years old woman presented to our clinic with bilateral painless decrease in vision for 5 to 6 months. Best corrected visual acuity was 20/640 in the right and 20/500 in the left eye. Slit lamp examination was unremarkable except bilateral pseudophakia. Intraocular pressures were within normal limits. Bilateral severe cystoid macular edema was identified in indirect retina examination and optical coherence tomography (OCT). Patient was prescribed oral capecitabine therapy 10 months ago, which was completed 4 months ago. There was no history of topical or systemic medication other than capecitabine. After treatment with oral acetazolamide and topical steroid and non-steroidal eye drops, best corrected visual acuity was increased to 20/200 in right eye and 20/63 in the left eye. On OCT, it was seen that cystoid macular edema was regressed in the right eye and disappeared in the left eye. This is the first case report about bilateral cystoid macula edema related to capecitabine therapy in the literature