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Background: Shear wave electrography (SWE) is a novel non-invasive imaging technique which demonstrate tissue elasticity. Recent research evaluating the elasticity properties of normal and pathological tissues emphasize the diagnostic importance of this technique. Aims: Polycystic ovarian syndrome (PCOS), which is characterized by menstrual irregularity, hyperandrogenism, and polycystic overgrowth, may cause infertility. The aim of this study was to evaluate the elasticity of ovaries in patients with PCOS using SWE. Methods: 66 patients diagnosed with PCOS according to the Rotterdam criteria (PCOS = group I) and 72 patients with non-PCOS (Control = group II), were included in the study. Demographic and clinical characteristics of the participants were recorded. Ovarian elasticity was assessed in all patients with SWE, and speed values were obtained from the ovaries. The elasticity of the ovaries was compared between the two groups. Results: While there were statistically significant differences between the groups in body mass index (BMI), right and left ovarian volumes, luteinizing hormone and testosterone levels (p Conclusion: We could not obtain different velocity and elastography values from the ovaries of the patients with PCOS using SWE. Therefore, further large-scale studies are needed to elucidate this issue.

Background: Digital mammography (DM) and digital breast tomosynthesis (DBT) are important radiological modalities, which increase the survival of breast cancer patients. Breast cancer is a morphologically heterogeneous disease with various histopathological parameters and multiple receptors in its biological profile. Objectives: This study aimed to analyze the morphological features of invasive breast cancer on DM and DBT, to investigate the contribution of DBT to DM, to examine the association of DBT findings with pathological molecular subtypes, Bloom-Richardson grade, and Ki-67 index, and to determine the effect of breast parenchyma density on the relationship between DBT findings and hormone receptors. Patients and Methods: A total of 36 patients with malignant lesions were evaluated in this study. According to the American College of Radiology (ACR) classification, the lesion features were divided into subgroups based on DM and DBT, and the findings were compared. The relationships between DBT findings and the hormone receptor status, molecular classification, and Bloom-Richardson grade were also investigated, and the effect of density on these relationships was assessed. Results: The mean age of the patients (n = 36) was 53 years. Based on the comparison of DM and DBT findings, spiculated margins, mass density, architectural distortion, and microcalcifications were significantly more frequent in DBT. Lesions with indistinct margins on DM were observed as mass lesions with spiculated margins on DBT (P < 0.001). Regarding the relationship between DBT findings and hormone receptor status and Ki-67 proliferation index, in progesterone receptor (PR)-positive patients, an irregular tumor shape was more common (89.7%). In PR-negative patients, skin changes and nipple retraction were more frequently seen (P = 0.03 for skin changes, and P = 0.049 for nipple retraction). Regarding the association between Bloom-Richardson grade (BRG) and DBT findings, tumors with a higher grade were more likely to be associated with a high tumor density (P = 0.032). Also, considering the relationship between molecular classification and DBT findings, skin changes and nipple retraction were significantly more frequent in triple-negative masses compared to other subtypes (P = 0.011 for skin changes and P = 0.016 for nipple retraction). Conclusion: DBT is superior to DM, as it reveals the lesion margins, density, and architectural distortion more accurately. The majority of PR-positive tumors were irregular, while most PR-negative cases were round. The mass density also increased as the tumor grade increased. Skin change and nipple retraction were frequently seen in triple-negative tumors compared to other subtypes. Therefore, DBT is a promising diagnostic tool for showing molecular subtypes in dense breasts.

Background: Digital mammography (DM) is one of the most common and effective radiological methods for breast cancer screening and detection. A dense fibroglandular breast tissue can lead to false negative results by superimposing on the lesion margins. Therefore, adjunctive imaging methods, such as digital breast tomosynthesis (DBT) and ultrasonography (US), are needed to increase mammographic sensitivity. Objectives: This study aimed to examine the contribution of US and DBT to DM in different patient groups (patients group of breast imaging-reporting and data system [BIRADS] 0 and 3-4 lesions, patients with dense breast parenchyma, patients with non-dense breast parenchyma).. Whether US and DBT can upgrade or downgrade the BI-RADS category of uncertain lesions detected on DM was also investigated. Patients and Methods: Forty-six patients, who were classified as BI-RADS categories 0, 3, and 4 in DM, according to DBT and US findings, were included in the study. DM followed by DBT was performed for the patients, and the BI-RADS classification system was applied. Subsequently, the patients were evaluated sonographically, and the BI-RADS system was applied according to the US results. Each BI-RADS category was compared with the histopathological and multimodality follow-up results. The diagnostic performance of all modalities was also examined alone and in combination. Results: The sensitivity and specificity of DM alone was 42% and 87%, respectively. DBT detected the lesions with 92% sensitivity and 68% specificity. The modality with the highest sensitivity for the detection of malignant lesions was US (100%). Besides, the specificity of DBT was significantly high for dense breasts (P < 0.001). There was no significant difference in terms of the diagnostic accuracy of US measurements between dense and non-dense breasts. For indeterminate lesions, the integration of DBT and US to DM increased the diagnostic accuracy. Conclusion: The contribution of DBT is more valuable than US in patients with dense breast parenchyma.

Mondor's disease, sclerosing thrombophlebitis of superficial veins of the anterior chest wall. It was first described by Henri Mondor in 1939. Antibiotics, steroids, anticoagulants were used in the treatment, but no significant benefit was found. Symptomatic measures are sufficient for treatment. Mondor's disease is a self-limiting benign disease. Between 3 weeks and 6 months there is an improvement. Careful research should be done in these cases as there may be occult cancers in other regions. In this case, we aimed to discuss breast disease which is a rare phenomenon with the ultrasound images of Mondor’s disease to indicate the importance of ultrasound in diagnosis and follow-up.

Current guidelines recommend administration of high-dose statins in acute coronary syndrome (ACS). It has been reported that statins upregulate proprotein convertase subtilisin kexin 9 (PCSK9) mRNA expression and increase circulating PCSK9 levels. We aimed to compare the effects of high-dose atorvastatin and rosuvastatin on serum oxidized low-density lipoprotein (oxidized-LDL) and PCSK9 levels in statin-naive patients with ACS.One hundred and six patients with ACS were enrolled in this study. The patients were assigned randomly to receive atorvastatin (80 mg/day) or rosuvastatin (40 mg/day) by using a ratio of 1 : 1 in randomization. The levels of total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol, LDL-cholesterol, oxidized-LDL, and PCSK9 were compared between groups after a 4-week treatment.Our study population included 53 patients in the atorvastatin group (age: 58.13±11.30 years, 11.32% female) and 53 patients in the rosuvastatin group (age: 59.08±12.44 years, 15.09% female). In both groups, lipid parameters, oxidized-LDL, and PCSK9 values changed significantly according to the baseline following treatment. High-dose atorvastatin and rosuvastatin induced similar decreases in LDL-cholesterol, oxidized-LDL, and triglyceride levels and similarly increased in high-density lipoprotein cholesterol and PCSK9 levels (P0.05).We showed that atorvastatin and rosuvastatin treatment regimens have comparable effects on lipid parameters and PCSK9 levels in ACS patients.

Secretory adenosis (SA) of breast is rarely seen benign breast lesion, which might be associated with increased risk for breast carcinoma. SA is an extremely rare lesion, the cases reported in the literature and long-term follow-up studies are limited and radiological and histopathological diagnosis of SA is mostly challenging; it could be frequently misinterpreted as ductal carcinoma in situ. Because of these reasons; clinical significance and management of SA is still not fully understand and relative risk of SA is still not well-established. Herein; we presented mammography, ultrasound, magnetic resonance imaging and microscopic findings in a patient with SA of breast.

OBJECTIVE: In this prospective study, the diagnostic performance of the new version of superb microvascular imaging (SMI) in differentiating malignant from benign lesions was evaluated. MATERIAL AND METHODS: Ninety breast lesions were included. During color SMI examination, both free-hand region of interest (ROI) and box ROI were used. Vascular index (VI) values were obtained from the lesion using both types of ROI and from normal breast tissue via box ROI. VI values, monochrome SMI grading and histopathological results were compared. The efficacy of color SMI and monochrome SMI was investigated in differentiating between benign and malignant breast lesions. RESULTS: The cut-off value, in the differentiation of benign and malignant lesions with color SMI was 0.50 for box ROI, while it was 0.30 for free-hand ROI. The specificity of VI values obtained with box ROI was higher than that of free-hand ROI when differentiating malignant lesions from benign. Comparison of VI values from a lesion and from normal breast tissue showed that VI values in malignant lesions were significantly higher (p

BACKGROUND: The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high-density lipoprotein (HDL) cholesterol level, reduces the low-density lipoprotein (LDL) cholesterol level, and enhances cellular cholesterol efflux capacity. We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. METHODS: In a multicenter, randomized, double-blind, placebo-controlled phase 3 trial, we enrolled 12,092 patients who had at least one of the following conditions: an acute coronary syndrome within the previous 30 to 365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease. Patients were randomly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo, administered daily, in addition to standard medical therapy. The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina. RESULTS: At 3 months, a 31.1% decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0% increase with placebo, and a 133.2% increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6% increase with placebo. After 1363 of the planned 1670 primary end-point events had occurred, the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy. After a median of 26 months of evacetrapib or placebo, a primary end-point event occurred in 12.9% of the patients in the evacetrapib group and in 12.8% of those in the placebo group (hazard ratio, 1.01; 95% confidence interval, 0.91 to 1.11; P=0.91). CONCLUSIONS: Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease. (Funded by Eli Lilly; ACCELERATE ClinicalTrials.gov number, NCT01687998 .).

WOS: 000516769700001, PubMed: 32107796, Pulmonary artery aneurysm (PAA) is a rare entity with fatal complications. Its silent course contributes to large aneurysms with compression symptoms. We present a 39-year-old female idiopathic pulmonary arterial hypertension patient with a giant PAA causing severe pulmonary regurgitation (PR) and symptomatic left main coronary artery compression (LMCA). Since she had a failed LMCA stenting attempt, she underwent surgery. A valve-sparing David-like pulmonary trunk reconstruction and coronary artery bypass were performed. This case illustrates that David-like reconstruction procedure can be applied to the PAA with severe PR.

Yenercag, Mustafa/0000-0002-0933-7852; YILMAZ, MEHMET BIRHAN/0000-0002-8169-8628; Demircioglu, Sinan/0000-0003-1277-5105; pekkolay, zafer/0000-0002-5323-2257; Kaynar, Leylagul/0000-0002-2035-9462; durmus, rana berru/0000-0001-9182-2760 WOS: 000427639800007 PubMed: 29407887 Background and aims: Homozygous familial hypercholesterolemia (HoFH) is a genetic condition characterized by lethally high levels of low-density lipoprotein cholesterol (LDL-C) from birth, and requires rapid and aggressive intervention to prevent death due to coronary heart disease and/or atherosclerosis. Where available, lipoprotein apheresis (LA) is the mainstay of treatment to promote survival. Methods: A-HIT1 registry was conducted with the aim of providing insight to the real-life management of HoFH patients undergoing LA in Turkey, where LA procedures are fully reimbursed and widely available. Participating centers provided patient information, including family history, treatment patterns and relevant laboratory values, via a standard questionnaire. Results: The study evaluated 88 patients (mean age: 27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA with a clinical diagnosis of HoFH. Mean age at first symptom disease was 10 +/- 10 years, and at diagnosis it was 12 +/- 11 years; 74.7% were diagnosed before age 15 years; and only 31% before the age of 7. First referral of most patients was to pediatricians. Early onset coronary artery disease was present in 57.8% of patients. Mean age at first LA was 21 +/- 12 years. Only 11 (12.5%) patients were undergoing LA weekly. Mean frequency of apheresis sessions was 19 +/- 13 days. For the last four LA sessions, LDL-C levels reached the target in only in 5.7% of patients. Conclusions: Diagnosis of HoFH is delayed, and LDL targets are not reached. LA frequencies are not optimal. Urgent attention is needed to support the survival of patients with HoFH. (c) 2018 Elsevier B.V. All rights reserved. Aegerion pharmaceuticals; Amryt Pharmaceuticals This investigator initiated study was funded by Aegerion pharmaceuticals, and authors wish to thank Nigel Eastmond of Eastmond Medicomm Ltd for assistance in editing the final manuscript, which was funded by Amryt Pharmaceuticals.

Wunderlich syndrome (WS) is a rare acute abdominal condition, which is characterized with spontaneous nontraumatic renal haemorrhage into the subcapsular and perirenal spaces. Renal cell carcinoma, angiomyolipoma, renal cysts, vasculitis or blood dyscrasias are among the known risk factors. We report a case of Wunderlich's syndrome in an 59 year old woman associated with massive retroperitoneal hemorrhage.

WOS: 000456192300008, Background: The placenta is a soft organ with vital importance. Increased placental stiffness was reported in pathological conditions emerging during pregnancy, such as diabetes mellitus and hypertension. Nowadays, placental stiffness can be quantitatively measured using the shear wave elastography (SWE) technique. Objectives: We aimed to assess the factors affecting elasticity by finding the normal elastogram values of healthy pregnancy placentas using the SWE technique due to the importance of early diagnosis in risky pregnancies. Patients and Methods: In total, 288 healthy pregnant women in the second or third trimester were included in our prospective study. The pregnant women who had pathology in their fetus and its appendices or a posteriorly located placenta were excluded from the study. Obstetric ultrasonography and a placental elasticity assessment were performed in all the pregnant women. Speed values were obtained from five different locations of the placenta, including the central S1, S2, S3, S4 and peripheral P regions. The elasticity of the regions were compared, and the factors affecting elasticity were investigated. Results: There were significant differences among the velocity values obtained from five different areas of the placenta. The mean velocityvalues obtained from the central region were higher than those of the peripheral region (P < 0.001). There was also a significant difference in the mean velocity measurements obtained from the central region (P < 0.001). The hardest region of the placenta was the maternal surface, while the softest region was the peripheral surface. The elastographic velocityvalues of the placenta were found to correlate with maternal age, body mass index, placental localization, thickness, and grade, whereas it did not correlate with gravidity, parity, gestational week, and amniotic fluid index. Conclusion: The elasticity of the placenta varied according to the region and surface, whereas it did not change according to gestational week. It may be convenient to use the elasticity values obtained by SWE from specified regions in the follow-up of placentas in high-risk pregnancies. However, considering the affecting factors and contradictory study results, a large number of large-scale studies is required to strengthen the efficiency of SWE in the placental assessment.

WOS: 000475544900016, PubMed: 30928440, BACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening inherited disease leading to early-onset atherosclerosis and associated morbidity. Because of its rarity, longitudinal data on the management of HoFH in the real world are lacking, particularly on the impact the condition has on quality of life (QoL), including the impact of the extracorporeal lipid removal procedure apheresis (LA). METHODS: The A-HIT1 study included 88 patients with HoFH aged >= 12 years receiving regular LA in 19 centers in Turkey. Demographic and disease characteristics data were obtained. For patients aged >= 18 years, additional data on psychosocial status were obtained via the SF-36 score, the Hospital Anxiety and Depression Scale, and a HoFH-specific questionnaire. RESULTS: There was no standardized approach to therapy between centers. Mean (+/-SD) frequency of LA sessions was every 19.9 (+/-14) days, with only 11.6% receiving LA weekly, and 85% of patients were not willing to increase LA frequency. The most common concerns of patients were disease prognosis (31%), and physical, aesthetic, and psychological problems (27.5%, 15.9%, and 11.6%, respectively). Lower age at diagnosis was associated with better QoL, lower anxiety, improved functioning, and greater emotional well-being compared to later diagnosis. CONCLUSIONS: These findings demonstrate that adult patients with HoFH undergoing LA, experience significant impairment of QoL with an increased risk of depression. From patients' point of view, LA is time-consuming, uncomfortable, and difficult to cope with. The speed of diagnosis and referral has a considerable impact on patient well-being. (C) 2019 National Lipid Association. All rights reserved., Aegerion pharmaceuticals; Amryt Pharmaceuticals DAC, This investigator initiated study was funded by Aegerion pharmaceuticals, and authors wish to thank Nigel Eastmond of Eastmond Medicomm Ltd for assistance in editing the final article, which was funded by Amryt Pharmaceuticals DAC.

WOS: 000493983800007, PubMed: 31674929, Objective: Endocan, chemerin, and galectin-3 are discrete biomarkers associated with cardiovascular diseases and acting through different pathophysiological pathways. The aim of this study is to investigate and compare the effects of high doses of atorvastatin and rosuvastatin on serum endocan, chemerin, and galectin-3 levels in patients with acute myocardial infarction (AMI). Methods: Sixty-three patients with AMI were randomized to receive atorvastatin (80 mg/day) or rosuvastatin (40 mg/day) after percutaneous revascularization. Serum levels of endocan, chemerin, and galectin-3 were evaluated at baseline and after 4-week therapy. Results: Endocan levels were not decreased statistically significantly with atorvastatin 80 mg, but rosuvastatin 40 mg markedly decreased the levels of endocan according to baseline [from 110.27 (86.03-143.69) pg/mL to 99.22 (78.30-122.87) pg/mL with atorvastatin 80 mg and from 110.73 (77.28-165.22) pg/mL to 93.40 (70.48-115.13) pg/mL with rosuvastatin 40 mg, p=0.242 for atorvastatin 80 mg and p=0.014 for rosuvastatin 40 mg]. Chemerin levels significantly decreased in both groups according to baseline [from 264.90 (196.00-525.95) ng/mL to 135.00 (105.95-225.65) ng/mL with atorvastatin 80 mg and from 309.95 (168.87-701.27) ng/mL to 121.25 (86.60-212.65) ng/mL with rosuvastatin 40 mg, p, Selcuk UniversitySelcuk University, of this article presented as poster abstract at the 23rd International Congress of Clinical Chemistry and Laboratory Medicine Congress, helded at the Durban International Convention Center in Durban, South Africa on October 22-25, 2017. This study was supported by Scientific Research Project Coordinator of Selcuk University and the founding source did not involve in study design, in the collection, analysis, and interpretation of data; in the writing of the report; in the decision to submit the article for publication.

WOS: 000458593300004, PubMed: 30476633, …

WOS: 000417845400001, PubMed: 29233116, Background: The aim of the present study was to establish the normal ranges for foetal nasal bone length (NBL), prenasal skin thickness (PNT), interocular distance (IOD), and ratio of prenasal thickness to- nasal bone length (PNT/NBL) at 18-24 weeks using two-dimensional (2D) ultrasound.& para;& para;Methods: This study was a retrospective study of prenatal ultrasonographic records from 407 foetuses between 18 and 24 weeks gestational age (GA). The NBL, PNT, IOD, PNT/NBL ratio, biparietal diameter (BPD), and femur length (FL) were investigated. The relationships among NBL, PNT, IOD, PNT/NBL, and GA were evaluated. Additionally, descriptive statistics for NBL, PNT, and SOD values for each gestational week were obtained.& para;& para;Results: There was a significant association between GA and NBL, PNT, and IOD between 18 and 24 weeks. NBL increased from a mean of 5.5 mm to 8.3 mm, PNT increased from a mean of 3.5 mm to 5.1 mm, and SOD increased from a mean of 11.1 mm to 14.5 mm. PNT/NBL ratio did not change with gestational age.& para;& para;Conclusions: This study showed normal ranges for NBL, PNT, IOD, and PNT/NBL ratios for foetuses between 18 and 24 weeks in low-risk pregnancies. There was a positive linear relationship between GA and NBL, PNT, and IOD. The PNT/NBL ratio might be a more useful measurement than NBL or PNT alone.

PubMed: 32423761 Background: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening disease due to high serum low-density lipoprotein (LDL) cholesterol levels. LDL cholesterol–lowering interventions are fundamental for patients with HoFH. Objective: It was aimed to investigate the association between the mental status of patients with HoFH and healthy lifestyle behaviors. Methods: This subgroup analysis of the A-HIT1 population included the data of patients aged ?18 years with a clinical diagnosis of HoFH undergoing therapeutic LDL apheresis. Besides the demographic and clinical characteristics of patients, healthy lifestyle behaviors were assessed, and psychiatric symptoms were screened by Symptom Check List (SCL-90-R). Results: The highest percentage for pathology was observed in dimensions of obsessive-compulsive, somatization, interpersonal sensitivity, and depression in SCL-90-R. Patients with any cardiovascular condition have more psychiatric symptoms in different fields of SCL-90-R. The outcomes of the correlative analysis indicated that lower the age of the first coronary event better the psychiatric status, probably denoting a better adaptation to disease and its treatment. Among 68 patients, 36 patients were not exercising regularly. Patients with regular physical activity had significantly lower scores in most dimensions of SCL-90-R and there was no association between regular physical activity and other investigated variables. The strongest predictor of regular exercising was global severity index of SCL-90-R. Conclusion: In the HoFH population, there was a high prevalence of mental disturbances. Better psychiatric status was associated with regular exercising. Therefore, assessing the mental status of patients with HoFH and referring patients in need, to a psychiatrist, may improve the outcome of patients. © 2020 National Lipid Association Data collection of this investigator-initiated study was funded by Aegerion pharmaceuticals.

Mondor hastalığı ön göğüs duvarı ve meme yüzeyel venlerinin sklerozan tromboflebitidir. İlk kez 1939 yılında Henri Mondor tarafından tanımlanmıştır. Tedavisinde antibiyotikler, steroidler antikoagülanlar kullanılmıştır fakat belirgin faydası gösterilememiştir. Tedavisi semptomatiktir. Mondor hastalığı kendisini sınırlandıran benign bir hastalıktır. İyileşme 3 hafta ve 6 ay arasında gerçekleşir. Bu vakalarda memenin diğer bölgelerine ve eşlik edebilecek kanser ihtimaline karşı dikkatli bir araştırma yapılmalıdır. Bu vakada nadir bir meme hastalığı olan Mondor hastalığının tanısı ve takibinde ultrasonun önemini, hastanın ultrason bulguları ile tartışmayı amaçladık., Mondor's disease, sclerosing thrombophlebitis of superficial veins of the anterior chest wall. It was first described by Henri Mondor in 1939. Antibiotics, steroids, anticoagulants were used in the treatment, but no significant benefit was found. Symptomatic measures are sufficient for treatment. Mondor's disease is a self-limiting benign disease. Between 3 weeks and 6 months there is an improvement. Careful research should be done in these cases as there may be occult cancers in other regions. In this case, we aimed to discuss breast disease which is a rare phenomenon with the ultrasound images of Mondor’s disease to indicate the importance of ultrasound in diagnosis and follow-up.