Background

In the last decade, flow diverter (FD) devices are one of the widely used endovascular methods in the treatment of intracranial aneurysms. As the frequency of its use is increasing progressively, we thought that studies concerned with the use of FD at specific locations are helpful to clarify the efficacy and safety of FD as a treatment option in cerebral aneurysms. We represent our experiences in the treatment of posterior communicating artery (PCOM) aneurysms by FD devices aiming to assess its angiographic efficacy (complete aneurysm occlusion) and its related complications. This is a retrospective study of 47 patients harboring 47 PCOM aneurysms treated with Pipeline Embolization Device (PED). Acutely ruptured and non-saccular aneurysms were excluded from the study. Short- and mid-term radiological and clinical outcomes were analyzed.

Results

Procedure-related complications were observed in five patients (two ischemic events, two transient ischemic attacks (TIA), and one ipsilateral distal hemorrhage) with no procedure-related mortality. Complete aneurysm occlusion was encountered in 87.2%. In multivariable analysis, large-sized aneurysm and incorporated vessels were an independent predictor of non-occlusion (P = 0.026 and P = 0.035 respectively). A favorable clinical outcome (modified Rankin Scale, 0–2) was observed in 45/47 patients (95.7%); the incidence of postoperative complications was an independent predictor of unfavorable clinical outcomes (P = 0.048).

Conclusion

PED stent provides a high occlusion rate in the treatment of PCOM aneurysms with good post-treatment clinical outcomes.

Background

This study aimed to investigate the chest computed tomography (CT) characteristics and laboratory findings in patients with confirmed COVID-19 pneumonia and to evaluate their relationship with clinical outcome.

This retrospective study assessed 164 consecutive CT chests of COVID-19 patients during April 2020. The chest CT and laboratory data were analyzed. The primary endpoint was patient survival either died or survived. The relationship between CT and laboratory findings was correlated to patient outcome.

Results

The study group included 164 patients (86 male, 78 women; average age, 44.3 ± 16.5 years) whose RT-PCR were positive for COVID-19. Only 120 (73.2%) patients had pulmonary manifestations. Ground glass opacities of peripheral distribution and multifocal affection were the major CT finding in COVID-19 patients. Univariate analysis revealed that CT severity score, D-dimer level, age, total leucocytic count, and absolute lymphocytic count were predictive for death.

Conclusion

CT has an emerging role in the diagnosis of COVID-19 pneumonia and in assessing disease severity. CT severity score, D-dimer, total leucocytic count, and absolute lymphocytic count significantly predict patient survival.

Background

Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality.

Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences.

Results

In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively.

Conclusion

MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

Purpose: We aimed to assess the efficacy and safety of flow-diverter stents (FDs) in the management of posterior circulation cerebral aneurysms and compare FD efficacy between anterior and posterior circulation aneurysms.

Methods: We searched the PubMed, Scopus, Cochrane, and Web of Science databases for relevant studies through March 2020. Studies assessing FDs for posterior circulation aneurysms that included ≥20 treated aneurysms were included. Moreover, the studies compared FD efficacy between anterior and posterior circulation aneurysms were included. Data regarding angiographic aneurysmal occlusion, procedural complications, mortality, and morbidity were extracted and pooled in a random-effects meta-analysis model.

Results: Fourteen studies with a total of 659 patients and 676 posterior circulation aneurysms were included. The pooled rate of aneurysmal occlusion at long-term angiographic follow-up was 78% [95% confidence interval (CI), 71-85]. The pooled rates of intraparenchymal hemorrhage, ischemia, and procedure-related mortality and neurological morbidity were 2%, 8%, 7%, and 6%, respectively. Complete occlusion occurred in 82.4% of the posterior circulation aneurysm subgroup and 77.5% of the anterior circulation aneurysm subgroup. The difference was not significant (relative risk 1.01; 95% CI, 0.86-1.19; p = 0.91). Regression analysis showed that elderly patients and females had higher morbidity.

Conclusion: Posterior circulation aneurysms can be effectively treated with FDs with comparable occlusion rates to those in anterior circulation aneurysms. However, periprocedural complications are not negligible.

Background

The Radiological Society of North America (RSNA) recently published a chest CT classification system and Dutch Association for Radiology has announced Coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) to provide guidelines to radiologists who interpret chest CT images of patients with suspected COVID-19 pneumonia. This study aimed to compare CO-RADS and RSNA classification with respect to their sensitivity and reliability for diagnosis of COVID-19 pneumonia.

Results

A retrospective study assessed consecutive CT chest imaging of 359 COVID-19-positive patients. Three experienced radiologists who were aware of the final diagnosis of all patients, independently categorized each patient according to CO-RADS and RSNA classification. RT-PCR test performed within one week of chest CT scan was used as a reference standard for calculating sensitivity of each system. Kappa statistics and intraclass correlation coefficient were used to assess reliability of each system. The study group included 359 patients (180 men, 179 women; mean age, 45 ± 16.9 years). Considering combination of CO-RADS 3, 4 and 5 and combination of typical and indeterminate RSNA categories as positive predictors for COVID-19 diagnosis, the overall sensitivity was the same for both classification systems (72.7%). Applying both systems in moderate and severe/critically ill patients resulted in a significant increase in sensitivity (94.7% and 97.8%, respectively). The overall inter-reviewer agreement was excellent for CO-RADS (κ = 0.801), and good for RSNA classification (κ = 0.781).

Conclusion

CO-RADS and RSNA chest CT classification systems are comparable in diagnosis of COVID-19 pneumonia with similar sensitivity and reliability.

Recent developments in the literature have demonstrated that curcumin exhibit antioxidant properties
supporting its anti-inflammatory, chemopreventive and antitumoral activities against aggressive and
recurrent cancers. Despite the valuable findings of curcumin against different cancer cells, the clinical
use of curcumin in cancer treatment is limited due to its extremely low aqueous solubility and instability,
which lead to poor in vivo bioavailability and limited therapeutic effects. We therefore focused in the present
study to evaluate the anti-tumor potential of curcumin analogues on the human breast carcinoma
cell lines MDA-MB-231 and MCF-7, as well as their effects on non-tumorigenic normal breast epithelial
cells (MCF-10). The IC50 values of curcumin analogue J1 in these cancer cell lines were determined to be 5
ng/ml and 10 ng/ml, in MDA-MB-231 and MCF-7 cells respectively. Interestingly, at these concentrations,
the J1 did not affect the viability of non-tumorigenic normal breast epithelial cells MCF-10. Furthermore,
we found that J1 strongly induced growth arrest of these cancer cells by modulating the mitochondrial
membrane potentials without significant effect on normal MCF-10 cells using JC-1 staining and flow
cytometry analysis. Using annexin-V/PI double staining assay followed by flow cytometry analysis, we
found that J1 robustly enhanced the induction of apoptosis by increasing the activity of caspases in
MDA-MB-231 and MCF-7 cancer cells. In addition, treatment of breast cancer cells with J1 revealed that,
in contrast to the expression of cyclin B1, this curcumin analogue vigorously decreased the expression of
cyclin A, CDK2 and cyclin E and subsequently sensitized tumor cells to cell cycle arrest. Most importantly,
the phosphorylation of AKT, mTOR and PKC-theta in J1-treated cancer cells was markedly decreased and
hence affecting the survival of these cancer cells. Most interestingly, J1-treated cancer cells exhibited a
significant inhibition in the activation of RhoA followed by reduction in actin polymerization and
cytoskeletal rearrangement in response to CXCL12. Our data reveal the therapeutic potential of the
curcumin analogue J1 and the underlying mechanisms to fight breast cancer cells.