Search

We present a case of idiopathic membranous glomerulonephritis that presented with venous thromboembolism and was successfully managed with corticosteroid, cyclosporin, appropriate anticoagulant therapy. A 59-year old male patient was referred to our nephrology department who had an outpatient history of swelling in the feet and flank pain was detected proteinuria and thrombosis in the inferior vena cava. Warfarin sodium treatment was started when thrombus was detected in the femoral vein, renal vein and inferior vena cava in the imaging. The patient had 12 g/day proteinuria, hypoalbuminemia, hyperlipidemia and antiphospholipase A2 receptor antibody positivity and treatment was started with the diagnosis of idiopathic membranous nephropathy. The patient who was discharged with oral steroid, cyclosporine and warfarin sodium, but warfarin sodium was changed to rivaroxaban in another clinic due to incompatibility problems, was presented again with dsypnea. Pulmonary embolism was detected. Rivaroxaban was discontinued and low molecular weight heparin treatment was started. There was a very high risk of morbidity and mortality and with appropriate treatment, clinical status and renal function were stabilized. In conclusion, although thromboembolism can be seen in nephrotic syndrome, it may rarely be encountered as the first presentation of nephrotic syndrome. This situation should not be overlooked, appropriate treatments should be provided without delay., Venöz tromboembolizm ile prezente olan ve kortikosteroid, siklosporin, uygun antikoagülan tedavi ile başarılı bir şekilde tedavi edilen bir idiyopatik membranöz glomerülonefrit olgusu sunuyoruz. Ayaklarda şişlik, yan ağrısı şikayetleri olan 59 yaşında erkek hastada proteinüri ve vena cava inferiorda tromboz tespit edilmesi sonucu nefroloji bölümümüze sevk edildi. Görüntülemede femoral ven, renal ven ve inferior vena cavada trombüs saptanması üzerine varfarin sodyum tedavisi başlandı. 12 g/gün proteinüri, hipoalbüminemi, hiperlipidemi ve anti fosfolipaz A2 reseptör antikor pozitifliği saptanan hastaya idiyopatik membranöz nefropati tanısı ile tedavi başlandı. Oral steroid, siklosporin ve varfarin sodyum ile taburcu edilen ancak uyumsuzluk nedeniyle başka bir klinikte varfarin sodyum rivaroksaban ile değiştirilen hasta nefes darlığı şikayeti ile tekrar başvurdu. Pulmoner emboli tespit edilmesi üzerine rivaroksaban kesildi ve düşük molekül ağırlıklı heparin tedavisi başlandı. Çok yüksek bir morbidite ve mortalite riski vardı ve uygun tedavi ile klinik durum ve böbrek fonksiyonu stabilize edildi. Sonuç olarak, nefrotik sendromda tromboemboli görülebilmesine rağmen, nefrotik sendromun ilk prezentasyonu olarak nadiren de olsa tromboemboli ile karşılaşılabilinir. Bu durum gözden kaçırılmamalı, uygun tedaviler geciktirilmeden sağlanmalıdır.

ObjectiveTo determine GPT-4’s effectiveness in writing scientific radiology article abstracts and investigate human reviewers’ and AI Content detectors’ success in distinguishing these abstracts. Additionally, to determine the similarity scores of abstracts generated by GPT-4 to better understand its ability to create unique text.MethodsThe study collected 250 original articles published between 2021 and 2023 in five radiology journals. The articles were randomly selected, and their abstracts were generated by GPT-4 using a specific prompt. Three experienced academic radiologists independently evaluated the GPT-4 generated and original abstracts to distinguish them as original or generated by GPT-4. All abstracts were also uploaded to an AI Content Detector and plagiarism detector to calculate similarity scores. Statistical analysis was performed to determine discrimination performance and similarity scores.ResultsOut of 134 GPT-4 generated abstracts, average of 75 (56%) were detected by reviewers, and average of 50 (43%) original abstracts were falsely categorized as GPT-4 generated abstracts by reviewers. The sensitivity, specificity, accuracy, PPV, and NPV of observers in distinguishing GPT-4 written abstracts ranged from 51.5% to 55.6%, 56.1% to 70%, 54.8% to 60.8%, 41.2% to 76.7%, and 47% to 62.7%, respectively. No significant difference was observed between observers in discrimination performance.ConclusionGPT-4 can generate convincing scientific radiology article abstracts. However, human reviewers and AI Content detectors have difficulty in distinguishing GPT-4 generated abstracts from original ones.

Purpose: Horseshoe kidney is the most common fusion anomaly that congenital systemic and urological anomalies accompany most of the patients. In this study, we aimed to investigate its association with vascular anomalies and especially nutcracker syndrome along with accompanying urological and other systemic anomalies in children with horseshoe kidney. Materials and methods: Twenty-six patients are diagnosed with horseshoe kidney in our clinic and 22 healthy children of the same age and sex were included in the study. All children were prospectively evaluated using Doppler ultrasonography in terms of renal artery and renal vein flow velocities, lumen diameters and vascular anomalies and presence of nutcracker syndrome. Results: Urological anomaly was found in 50% of the children with horseshoe kidneys, and systemic anomaly in 44% of them. In Doppler ultrasonographic evaluations performed on patients to detect vascular pathologies and nutcracker syndrome; findings of nutcracker syndrome were present in 2 patients in the horseshoe kidney group, while they were detected incidentally in 1 patient in the control group. An accessory renal artery originating from the left common iliac artery was found in a case with horseshoe kidney, and a circumaortic left renal vein in one case. Conclusions: In our study in which we investigated nutcracker syndrome based on the presence of vascular anomalies accompanying horseshoe kidneys in children, nutcracker syndrome findings were found in similar numbers in both groups. However, we think that these children should be followed for a long time in terms of vascular pathologies (aneurysm, rupture) and malignancies that may occur in adulthood, as well as congenital vascular anomalies.

A 5-month-old male baby was brought to the emergency room with a one-day history of respiratory distress, wheezing, vomiting, and high fever. Wheezing had been present since birth but had recently become more frequent and intense, occurring even at rest. The baby was born full-term by cesarean delivery and had a medical history of gallbladder agenesis, secundum atrial septal defect (ASD), and cryptorchidism.

Swyer-James-MacLeod syndrome is a condition characterized radiologically by hyperlucency in a single lung lobe associated with reduced vascularity, alveolar hyperdistention, and air trapping in the absence of bronchial airway obstruction. Ventricular septal defect is the most common congenital heart defect in childhood and causes irreversible pulmonary hypertension and Eisenmenger syndrome if not treated in a timely manner. In this case report, we present a 25-year-old patient with Swyer-James-MacLeod syndrome and Eisenmenger syndrome. Including Swyer-James-MacLeod syndrome in the differential diagnosis of patients with atypically distributed pulmonary emphysema and unilateral hyperlucency is important for early diagnosis and timely treatment.

The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation. © 2021, AVES. All rights reserved.