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IntroductionChemical contamination and pollution are an ongoing threat to human health and the environment. The concern over the consequences of chemical exposures at the global level continues to grow. Because resources are constrained, there is a need to prioritize interventions focused on the greatest health impact. Data, especially related to chemical exposures, are rarely available for most substances of concern, and alternate methods to evaluate their impact are needed.Structured expert judgment (sej) processA Structured Expert Judgment (Research Outreach, 2021) process was performed to provide plausible estimates of health impacts for 16 commonly found pollutants: asbestos, arsenic, benzene, chromium, cadmium, dioxins, fluoride, highly hazardous pesticides (HHPs), lead, mercury, polycyclic-aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), Per- and Polyfluorinated Substances (PFAs), phthalates, endocrine disrupting chemicals (EDCs), and brominated flame retardants (BRFs). This process, undertaken by sector experts, weighed individual estimations of the probable global health scale health impacts of each pollutant using objective estimates of the expert opinions' statistical accuracy and informativeness.Main findingsThe foremost substances, in terms of mean projected annual total deaths, were lead, asbestos, arsenic, and HHPs. Lead surpasses the others by a large margin, with an estimated median value of 1.7 million deaths annually. The three other substances averaged between 136,000 and 274,000 deaths per year. Of the 12 other chemicals evaluated, none reached an estimated annual death count exceeding 100,000. These findings underscore the importance of prioritizing available resources on reducing and remediating the impacts of these key pollutants.Range of health impactsBased on the evidence available, experts concluded some of the more notorious chemical pollutants, such as PCBs and dioxin, do not result in high levels of human health impact from a global scale perspective. However, the chemical toxicity of some compounds released in recent decades, such as Endocrine Disrupters and PFAs, cannot be ignored, even if current impacts are limited. Moreover, the impact of some chemicals may be disproportionately large in some geographic areas. Continued research and monitoring are essential; and a preventative approach is needed for chemicals.Future directionsThese results, and potential similar analyses of other chemicals, are provided as inputs to ongoing discussions about priority setting for global chemicals and pollution management. Furthermore, we suggest that this SEJ process be repeated periodically as new information becomes available.

Abstract Background The importance of COVID-19 vaccination for patients on immunosuppressive (IS) medication has increased due to the high risk of severe disease or mortality. Different vaccines have varying efficacy rates against symptomatic COVID-19, ranging from 46.8% to 95%. The objective of this study was to examine the differences in anti-Spike IgG, anti-Spike IgA, and neutralizing antibody (NAb) activity between the inactive CoronaVac vaccine and the mRNA-based BNT162b2 vaccine in IS patients. Method A total of 441 volunteers, including 104 IS patients, 263 healthy controls (HC), who received two doses of CoronaVac or BNT162b2, and 74 unvaccinated patients with a history of SARS-CoV-2 infection, were included in the study. Anti-spike IgG, IgA, and NAb activity were investigated. Results Immunogenicity with BNT162b2 was higher than with CoronaVac, but in IS groups, it was lower than HC (CoronaVac-IS: 79.3%, CoronaVac-HC: 96.5%, p

Abstract Background One of the roles that nurses have acquired in recent years is the role of prescribing. This study aimed to investigate the knowledge and attitudes of critical care nurses, physicians and patients about nurse prescribing. Methods A descriptive cross-sectional study with the participation of 152 nurses, 53 physicians and 75 patients was carried out. Participants were selected by stratified random sampling from the critical care units of six hospitals in Tabriz, Iran. Demographics and participants’ knowledge and attitudes about nurse prescribing questionnaires were used to collect data. The collected data were analyzed using SPSS-22 software. Results The mean scores of total knowledge about nurse prescribing in nurses, patients and physicians’ were 15.41 ± 1.85,16.45 ± 2.31, 14.74 ± 1.7 respectively (from a range of 10 -20), and the mean score of knowledge by physicians was significantly higher than others (P = 0.000) and they had more knowledge about nurse prescribing. The mean scores of the attitudes towards nurse prescribing in nurses, physicians and patients were 40.62 ± 3.68, 37.98 ± 5.92 and 39.38 ± 4.39 respectively (from a range of 10 -50). However, the total mean score of attitudes among nurses was significantly higher than others (P = 0.000) and nurses had more positive attitudes toward prescribing. Conclusion The results showed that the participants have a good understanding and attitudes toward nurse prescribing. Nurse prescribing as a new duty and authority can be considered in providing more effective care by specialist nurses. The results of this study can also be used in the future planning of health policy for nurses to have the right to prescribe and ultimately improve the quality of patient care.

Objective. To test the predictions of fuzzy-trace theory regarding pediatric clinicians’ decision-making processes and risk perceptions about antibiotics for children with acute otitis media (AOM). Methods. We conducted an online survey experiment administered to a sample of 260 pediatric clinicians. We measured their risk perceptions and prescribing decisions across 3 hypothetical AOM treatment scenarios. Participants were asked to choose among the following options: prescribe antibiotics immediately, watchful waiting (“hedging”), or not prescribing antibiotics. Results. We identified 4 gists based on prior literature: 1) “why not take a risk?” 2) “antibiotics might not help but can hurt,” 3) “antibiotics do not have harmful side effects,” and 4) “antibiotics might have harmful side effects.” All 4 gists predicted risky choice ( P < 0.001), and gist endorsements varied significantly between scenarios when antibiotics were indicated, F (2, 255) = 8.53, P < 0.001; F (2, 255) = 5.14, P < .01; and F (2, 255) = 3.56, P < 0.05 for the first 3 factors, respectively. In a logistic regression, more experienced clinicians were less likely to hedge ( B = −0.05; P < 0.01). Conclusion. As predicted by fuzzy-trace theory, pediatric clinicians’ prescription decisions are associated with gist representations, which are distinct from verbatim risk estimates. Implications. Antibiotic stewardship programs can benefit by communicating the appropriate gists to clinicians who prescribe antibiotics for pediatric patients. Highlights We found clinicians’ antibiotic prescription decisions were driven by gist representations of antibiotic risks for a given hypothetical patient scenario, and clinicians’ gist representations and verbatim risk estimates about antibiotic-related risks were distinct from each other. We showed that the effect of patient scenarios on clinicians’ antibiotic prescription decisions was mediated by clinicians’ gist representations. Less experienced clinicians tend to “hedge” in their antibiotic prescription decisions compared with more experienced clinicians. The broader impact of our study is that antibiotic stewardship programs can benefit by communicating the appropriate gists to clinicians who prescribe antibiotics for pediatric patients, rather than solely focusing on closing potential knowledge deficits of the clinicians.

Purpose The Westernization and its reflections could be observed in the architecture, urbanism and social life in Istanbul in 19th century. The Tanzimat Edict (1839), Vienna Protocol (1855) and Islahat Edict (1856) affected the lifestyle of non-Muslims, especially in the administrative, religious and educational sphere. These political, legal and social reforms had also affected the Greek Orthodox community living in the Ottoman lands and their architectural activities about the churches. Therefore, the purpose of this paper is to clarify the restoration works of Galatasaray Panagia Church conducted in the 19th century based on the archival documents. Design/Methodology/Approach The archival documents provide a comprehensive understanding of the changes, repairs, architectural implementations and formal procedure of the restoration of the Greek Orthodox churches. The methodology of the paper is mainly to analyze the archival documents and do the field survey. The archival documents about the extension of the Galatasaray Panagia Church was analyzed in detail. Then field survey was done. Present-day conditions of the church was observed and compared with the archival documents. Moreover, the analogical research was done to understand the situation before the implementation in 19th century. Findings The archival documents were the important proofs of the interventions of the conservations, which were applied at the end of the 19th century. They give information about to the drawing techniques, characteristics of interventions, construction materials, construction sector, responsible authorities and the process of getting necessary permissions for the restoration and the details of labors. At the end of the 19th century, restoration process of the Greek Orthodox churches was changed with the removal of the restrictions. For example, the new construction materials were used from European countries. Research Limitations/Implications This study examines the archival documents to provide the information about the church and aims to underline the importance of these documents to understand the history of the church, as well as the conservation methodology and process in the 19th century. Practical Implications The archival documents are not merely materials to help understand the building better, but they also serve as tangible evidences of past restorations. The technical details that archival documents include, guide the decision process of the future interventions. Moreover, they provide reliable and valuable information about the later additions that must be conserved. Social Implications The Greek Orthodox community was one of the important non-Muslim groups, had a significant role in the Ottoman Empire. Considering the present-day conditions, most of the Greek Orthodox churches could survive owing to the extensive repairs, restorations or, in some cases, reconstructions. This study made an important contribution to the research on the Greek Orthodox churches, which has a small population today. Originality/Value Most studies on this subject is based on just classification of the archival documents. However, this study is focused to analyze the documents in detail with the observation on the structure. The originality of this study is both to analyze historical archival documents and to observe present-day conditions together. Thereby while the past restoration process was understood, future implementation are shed light on.

Introduction: With more than 40 million confirmed cases of COVID-19 globally, the pandemic is continuing to severely challenge health systems around the world. Countries with high numbers of refugees face an additional burden on COVID-19 preventive and curative services made available and accessible to refugees. Turkey hosts the largest number of refugees globally, with a total of 4 million in 2020. Over 98% of refugees in Turkey reside in urban areas in large, crowded cities such as Istanbul, Gaziantep, and Hatay posing severe challenges for all health responses, including COVID-19. This study provides insights and analysis on the current situation for refugees, migrants under temporary protection and undocumented migrants in Turkey by focusing on the right to health and access to health care under pandemic conditions. Its main aim is to discuss the challenges and opportunities for COVID-19 responses relating to refugees, migrants under temporary protection and undocumented migrants in Turkey. Methods: This is a non- systematic and exploratory literature review from academic and grey sources. We reviewed published documents, meeting summaries, media reports/news and policy briefs in Turkish and English on the COVID-19 response in Turkey. Results: Since the start of the COVID-19 outbreak in Turkey, the Ministry of Health (MoH) has taken various steps to provide health care for all residents. However, several challenges arise when providing health care to refugees, migrants under temporary protection and other undocumented migrants including language barrier in accessing reliable information and access to health services for existing chronic conditions. Conclusion: While refugees, migrants under temporary protection and undocumented migrants have been granted access to services for COVID-19 related health problems, social and cultural barriers remain beyond the current legislation. Solidarity and whole-of-society inclusive approaches should always be the guiding principles in the COVID-19 response.

Sanayi Devrimi ile birlikte doğan halkla ilişkiler (Hİ), tarihsel gelişim süreci içerisinde sürekli değişim göstererek günümüzde kamu ve özel sektörde geniş bir kullanım alanına sahip modern bir bilim dalı ve yönetsel bir fonksiyon olarak kabul edilmektedir. Küreselleşen iş dünyasının hızla değişen dinamik özelliklerine yanıt verecek şekilde gelişen ve hem kamuda hem de özel sektördeki önemini kanıtlayan halkla ilişkiler, iletişim sektöründeki akademisyenlerin başat ilgi alanlarının içerisinde yer almaktadır. Bu doğrultuda, Türkiye’de de halkla ilişkiler disiplinini konu edinen çok sayıda akademik makalenin literatüre kazandırıldığı görülmektedir. Bu literatürü kapsayan araştırmada, “Türkiye’de halkla ilişkiler akademisyenleri hangi alanlarda çalışıyor?” sorusu cevaplanmaya çalışılmış, aynı zamanda makalelerin çalışma alanlarının geçirdiği değişim ve halkla ilişkiler makalelerinin hangi akademik dergilerde yayımlandığı tespit edilmiştir. Toplam 301 adet makaleye; makale başlığı, özeti ve anahtar kelimeler üzerinden doküman analizi ve betimsel tarama ile içerik analizi uygulanmış; belirlenen 26 kategori, üç sınıflandırma altında sunulmuştur. En fazla makalenin dahil olduğu ilk üç kategori; “kamu yönetimi”, “kurumsal iletişim” ve “internet-web siteleri” olarak belirlenirken en az makalenin ait olduğu kategorilerin ise, “finansal Hİ” ve “bilgi toplumu” olduğu tespit edilmiştir.

A 29-year-old female patient presented with a painless mass on her upper eyelid medially. She noticed the mass 4 years earlier and it had increased in size over time. She had no diplopia, eyelid swelling, skin lesion overlying the mass, or visual disturbances. On ocular examination, eye movements and funduscopy were normal. The mass was movable and painless with palpation. Magnetic resonance imaging with contrast showed a 12x8x7 mm well-circumscribed cystic lesion with no contrast dye appearance. Surgical removal was performed delicately and no capsular rupture occured. Pathological examination revealed an eccrine hidrocystoma. Our aim is to underline that eccrine hidrocystoma should be included in differential diagnosis of orbital masses.

Dengue fever is a flavivirus infection transmitted through infected mosquitoes, and is endemic in Southeast Asia, Central and South America, the Pacific, Africa and the Eastern Mediterranean region. A 41-year-old male patient had visual impairment after travelling to Thailand, which is one of the endemic areas. Cotton wool spots were observed on fundus examination. Fundus fluorescein angiography showed minimal vascular leakage from areas near the cotton wool spots and dot hemorrhages in the macula. Dengue fever should be considered in patients with visual complaints who traveled to endemic areas of dengue fever. (Turk J Ophthalmol 2015; 45: 223-225)

Coal has remained the main source of energy in the UK from 1700 to the end of 1970s, and it still plays an important rolein the power generation. The paper discusses the current coal consumption in the UK together with environmental impacts of coalmining, coal processing and coal utilisation for power generation. Since coal remains the single biggest contributor to greenhouse gasesworldwide, methods for minimising environmental impacts of coal combustion are described in this paper including systematicapplication of the principles of clean coal technologies financed by the private sector.

Macular holes may occur secondary to a rhegmatogeous retinal detachment (RRD) caused by peripheral retinal breaks. We describe two patients with macula-off RRD with coexistent full-thickness macular hole (FTMH). Patients underwent vitrectomy + scleral buckling with internal tamponade (gas in case 1, and silicone oil in case 2). No internal limiting membrane (ILM) peeling was erformed. Both cases had attached retina with closed macular holes postoperatively, and vision increased in both patients. Macular hole closure was achieved by vitrectomy without ILM peeling in our cases. MH closure resulted in improved visual outcome. (Turk J Ophthalmol 2013; 43: 374-6

Purpose: To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period., Methods: A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours., Results: Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h., Conclusion: The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care., (© 2024 Wiley Periodicals LLC.)

Background: Low back pain is an important disability problem frequently encountered in the clinic. In the literature, it has been shown that neuropathic pain in chronic low back pain is quite common in patients. Although superior cluneal nerve entrapment syndrome is an underdiagnosed cause of low back and leg pain, differential diagnosis is very important anatomically and clinically. The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. In the literature, methods such as surgery, nerve blockade, prolotherapy, and acupuncture have been used in the treatment of cluneal nerve entrapment syndrome, but there are no studies on exercise. In this case report, our aim is to explain the importance of differential diagnosis in cluneal nerve entrapment syndrome, which is one of the common causes of low back pain in the clinic, and the effects of exercise in this disease., Case Presentation: A 22-year-old, Turkish-ethnicity, male patient with complaints of low back pain, neck-back pain, and weakness did not use alcohol or cigarettes. In his family history, there was a history of diabetes in the mother and diabetes and heart failure in the father. He had a history of osteoporosis, epilepsy, asthma, sarcoidosis, and cardiac arrhythmia. The patient reported that he suffered from constipation three to four times a month. As a result of the detailed evaluation, the planned exercise prescription was taught to the patient, and after it was confirmed that the patient did the exercises correctly for 3 days, the exercise brochure was given and followed as a home exercise program for 8 weeks., Conclusions: Lumbar stabilization exercises, gluteal muscle strengthening exercises, thoracolumbar fascia mobilization, and stretching exercises, which will be given in accordance with the clinical anatomy of the disease after the correct diagnosis in cluneal nerve entrapment syndrome, have been beneficial for the patient. However, we think that randomized controlled studies with a large sample will contribute to the literature., (© 2024. The Author(s).)

Introduction: The lamina papyracea is the thin line between the ethmoid sinus and the medial orbital wall. Knowledge of the presence of the lamina papyracea dehiscence (LPD) bears critical importance to prevent misdiagnosis of fractures at this level and to define the anatomy before sinonasal surgery, including Functional Endoscopic Sinus Surgery (FESS). The present study is therefore intended to determine the incidence of LPD in paranasal computed tomography, to identify its imaging characteristics in CT, and to compare with the literature., Materials and Methods: The current study included patients who underwent paranasal CT scanning for any reason in our clinic between January 2018 and January 2022. Patients were evaluated in terms of age, gender, and presence of LPD. Patients with dehiscence were evaluated in terms of age, gender, dehiscence localization (right, left), tissue at the level of dehiscence, dehiscence size, and dehiscence grade., Results: 1000 patients with a mean age of 32. ± 16.3 (min = 18-max = 79) were included in the study. 20 patients (2%) were found to have LPD. Of those with LPD, 14 (70%) were grade 1, 4 (20%) were grade 2 and 2 (10%) were grade 3. Again of those with LPD, 14 (70%) had LPD localized on the right and 6 (30%) had LPD on the left. In 12 (60%) of the patients with LPD, herniated tissue was detected. Among these patients with herniation, fatty tissue herniation was observed in 10 (83.3%) and medial rectus muscle herniation was observed in 2 (16.7%)., Discussion and Conclusion: Comprehensive evaluation for and identification of LPD are very important before possible sinus surgery., (© 2024. The Author(s).)

Objective: History, electrocardiogram, age, risk factors, troponin risk score and troponin level follow-up are used to safely discharge low-risk patients with suspected non-ST elevation acute coronary syndrome from the emergency department for a 1-month period. We aimed to comprehensively investigate the 6-month mortality of patients with the history, electrocardiogram, age, risk factors, troponin risk score., Methods: A total of 949 non-ST elevation acute coronary syndrome patients admitted to the emergency department from 01.01.2019 to 01.10.2019 were included in this retrospective study. History, electrocardiogram, age, risk factors, troponin scores of all patients were calculated by two emergency clinicians and a cardiologist. We compared the 6-month mortality of the groups., Results: The mean age of the patients was 67.9 (56.4-79) years; 57.3% were male and 42.7% were female. Six-month mortality was significantly lower in the high-risk history, electrocardiogram, age, risk factors, troponin score group than in the low- and moderate-risk groups: 11/80 (12.1%), 58/206 (22%), and 150/444 (25.3%), respectively (p=0.019)., Conclusion: Patients with high history, electrocardiogram, age, risk factors, troponin risk scores are generally treated with coronary angioplasty as soon as possible. We found that the mortality rate of this group of patients was lower in the long term compared with others. Efforts are also needed to reduce the mortality of moderate and low-risk patients. Further studies are needed on the factors affecting the 6-month mortality of moderate and low-risk acute coronary syndrome patients.

Purpose: The anterior ethmoidal artery (AEA) is an important risk area in endoscopic sinus surgery. This study aimed to evaluate the course of AEA according to the Keros classification and the presence of supraorbital ethmoid cell (SOEC) and to prevent possible complications by emphasizing the importance of preoperative paranasal computed tomography (CT) imaging. This approach will increase the effectiveness of endoscopic sinus surgery and improve patient safety., Methods: The paranasal CT scan images of patients aged > 18 years between October 2020 and November 2021 from our center were retrospectively analyzed. The images were primarily evaluated in the coronal plane, and the sagittal and axial planes were utilized to evaluate variations in AEA regarding the skull base. Furthermore, the relation of AEA course with Keros classification and SOEC was evaluated. The study included 1000 patients aged 18-80 years (right and left, a total of 2000 samples)., Results: Grade 3 AEA was the most common regarding the skull base. Keros Type 2 was the most common classification. Overall, 48.7% patients had SOEC. The incidence of Grade 3 AEA was higher among patients with SOEC and a higher Keros classification compared with those without SOEC and a lower Keros classification. Furthermore, Keros Type 3 was the most associated with SOEC presence., Conclusion: Consistent with the literature, the probability of Grade 3 AEA in patients with high Keros classification and SOEC was significantly higher in our study. Therefore, we consider that preoperative imaging according to Keros classification and SOEC presence can predict AEA course and guide surgery., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and objective Gynecomastia is a benign proliferation of ductal epithelium in the retroareolar region in male patients. The aim of this study was to investigate the frequency of gynecomastia in male patients who underwent thoracic computed tomography (CT) imaging at our clinic, assess possible causes, highlight the imaging characteristics of gynecomastia, and compare our findings with the literature. Materials and methods Male patients over 18 years of age who underwent thoracic CT imaging in our clinic were included in the study. Patients were initially assessed based on age and the presence of gynecomastia. The patients with gynecomastia were evaluated in terms of age, gynecomastia localization (right, left, and bilateral), gynecomastia type (nodular, dentritic, and diffuse), and possible etiology. Results The study included 1500 patients with a mean age of 45.6±21.7 years, and 470 (31.3%) patients had gynecomastia. Gynecomastia was on the right side in 11.3%, on the left side in 11.1%, and bilateral in 77.7% of the patients. Gynecomastia was nodular in 52.1%, dendritic in 35.3%, and diffuse in 17.2% of the patients. The causative factor could not be identified in 44.3% of the patients with gynecomastia. Among cases where the etiology was identified (56.7%), the most common factors were cancer (23.4%), chronic kidney disease (CKD) (13.2%), and chronic hepatitis B (10.7%). Conclusion When evaluating thoracic CT, the breast area, in addition to the lungs, chest wall, and bone structures, should also be evaluated carefully. With the increased use of thoracic CT scans, incidentally detected gynecomastia in patients is also on the rise. Knowing the presence of gynecomastia is very important for the clinician to determine the etiology and treat the underlying disease. Therefore, detecting and reporting gynecomastia on thoracic CT can prevent unnecessary advanced breast imaging methods and play a very important role in treating the underlying etiology., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Deniz et al.)

Background and objective CT imaging is important in detecting the location and the structure of swallowed foreign bodies and assessing their complications, due to its features such as the ability to show the detailed anatomical structure and enable multiplanar examination. In this study, we aimed to analyze the CT findings of swallowed foreign bodies located in the gastrointestinal tract and compare them with the data in the existing literature. Materials and methods We conducted a retrospective archive study to achieve our goals. Patients who presented to our radiology department with the preliminary diagnosis of foreign body ingestion, abdominal pain, or acute abdomen and were found to have a foreign body in the gastrointestinal tract on CT between April 2018 and April 2021, especially those in whom the presence of a foreign body was confirmed by endoscopy or surgery, were included in our study. The patients were evaluated in terms of age, gender, foreign body type, foreign body localization, and complications. Results A total of 31 patients (15 males and 16 females) were included in the study. The patients' age ranged from 1 to 67 years, and the mean age was 28.5 ±5.4 years. The most common foreign bodies found were metallic toy parts (n=11, 35%), and most of the foreign bodies were located in the ileum (n=9, 29%) of the patients. Complications were observed in nine patients (29%). In patients with complications, the most common finding was perforation (n=3, 38%). Conclusion When a CT exam is performed on patients with abdominal pain, the gastrointestinal tract should be carefully evaluated to determine if a foreign body is involved and to analyze the complications caused by the foreign body., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Deniz et al.)

Purpose: This study investigated the incidence of thyroid Zuckerkandl Tubercle (ZT) using a computed tomography (CT) scan of the neck with contrast to identify the typologies in ZT-positive CT scans, investigate the presence of nodules located in that area, and compare the results with the relevant literature., Methods: We selected and retrospectively examined the CT scan images of patients who presented to our clinic with CT scans of the neck with contrast that clearly showed thyroid tissue and boundaries. Patients were evaluated based on age, gender, and presence of thyroid ZT. Patients with thyroid ZT were further investigated for localization and type of tubercles as well as for presence of nodules at the tubercle level., Results: A total of 1000 patients (mean age: 48.4 ± 19.1) were included in the study. Out of the total 222 (22.2%) patients who had thyroid ZT, 134 (60.4%) patients had unilateral thyroid ZT on the right side and 29 (13.1%) patients had unilateral thyroid ZT on the left side; 59 (26.6%) patients had bilateral thyroid ZT. In addition, nodules at the ZT level were observed in 13 (1.3%) of the patients. A review of all cases with ZTs indicated that 63% were Type 1, 31% were Type 2, and 5% were Type 3., Conclusion: During the thyroid operations, ZT is essential for locating the recurrent laryngeal nerve. Reporting the presence of ZTs based on CT scans is crucial because it can prevent unnecessary interventional procedures, misdiagnoses, and likely complications in patients with planned thyroid operations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Purpose: This study aimed to investigate the prevalence of persistent trigeminal arteries (PTAs) using computed tomography (CT) angiography, emphasize its major characteristics, and compare the findings with those reported in the relevant literature., Methods: Patients who underwent cerebral CT angiography in our radiology clinic for any preliminary diagnosis between December 2013 and December 2020 were included in this retrospective study. The patients were reviewed in terms of their age, sex, and the presence of PTAs. The localization of the PTA, vascular connection, PTA type (according to Saltzman and Salas classification), and vascular pathology at the level of anastomoses were examined in the patients with PTAs., Results: A total of 1150 patients, (632 [55%] males and 518 [45%] females) were included in this study. A total of seven (0.6%) patients had PTAs. PTAs were located on the right and left sides in three (43%) and four (57%) patients, respectively. A total of three (43%), two (28%), and two (28%) cases were classified as types I, II, and III PTA based on the Saltzman classification, respectively. Moreover, four (57%) and three (43%) cases were lateral and medial types based on the Salas classification, respectively., Conclusion: In conclusion, understanding the diagnosis and classification of PTAs is crucial for the diagnosis of possible vascular pathologies by neuroradiologists and physicians performing neurovascular interventional procedures or operations. If these vascular pathologies remain undetected, they may cause fatal bleeding or embolism during surgeries and endovascular procedures., (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)

Background/aim: Magnetic resonance (MR) images, signal intensity ratios calculated using region of interests (ROI) in T2W images by proportioning the dominant myoma to iliac muscle can aid patient selection and, thus, in achieving better outcomes with the uterine artery embolization (UAE) procedure. The present study investigates the association between the success of UAE treatment with signal intensity (SI) ratio of the dominant myoma to the iliac muscle in MR imaging performed prior to the procedure., Materials and Methods: This is a retrospective study and included 30 patients who admitted to our clinic between February 2017 and July 2019 due to symptoms associated with myoma and who underwent MR imaging before and after UAE treatment. All patients, MR images obtained before UAE treatment and at the 12th month after the procedure were evaluated. In MRI, SI values were calculated by proportioning the dominant myoma to the iliac muscle using circular ROI in T1 weighted (W), T2W, and post-contrast T1W images. In the present study, 50% or more volumetric regression of the myoma with infarction of fibroids (loss of enhancement) at the 12-month follow-up MRI after the procedure was considered a successful procedure., Results: Myoma volumes calculated in MR images showed significant differences between the MRI performed before UAE procedure and the MRI performed at the 12th month after the procedure (p < 0.0001). SI ratio calculated from pre-procedure T2W MR images was found to be a significant determinant of 50% or more volumetric regression in the myoma after UAE procedure (p = 0.017), T1W, post-contrast T1W images were not statistically significant (p = 0.211)., Conclusion: Our results indicate that SI ratio of the dominant myoma to the iliac muscle calculated using ROI in T2W images of MR studies performed before UAE procedure can predict the success of the procedure., Competing Interests: none declared., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Introduction Excess iron accumulation occurs mainly in organs such as reticuloendothelial cells, the pituitary gland, and the pancreas in beta-thalassemia because of blood transfusions. In the present study, it was aimed to investigate the relationship between T2* values on magnetic resonance imaging (MRI) and clinically diagnosed pituitary endocrinological disorders in children with thalassemia major. Methods This study enrolled patients diagnosed with beta-thalassemia at pediatric hematology outpatient clinics. In the study, in addition to the medical history of the patients, routinely performed tests, including hemoglobin electrophoresis, routine biochemical tests, and tests for pubertal development (follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, etc.), as well as iron deposition measured by hepatic MRI T2* (STAR) sequence, were retrospectively assessed. A total of 29 patients were enrolled. Results Hypothyroidism was detected in 34.6% (9/26) of patients, short stature in 37% (10/27), and pubertal retardation in 50% (14/28) of the patients. There was no significant correlation between hypothyroidism and pituitary MRI T2* values. No significant correlation was found between laboratory parameters and pituitary MRI examination. Although the sensitivity of T2* levels could rise above 80%, their specificity remained low. This is one of the major limitations of the pituitary MR T2* study for the prediction of short stature. The best lower cut-off level of MR T2* to predict short stature was found 14.6 ms. Conclusion The diagnostic specificity pituitary MR examination levels for short stature were detected as low. Thus, the clinical standardization and validation of pituitary MR T2* values examination are needed before clinical follow-up and multifaceted studies are needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Yılmaz et al.)

Background and Aim: The aim of this study is to investigate the magnetic resonance imaging (MRI) of patients with lumbar disc herniation (LDH) to identify the challenges associated with neuraxial anesthesia., Materials and Methods: The MRI images in the supine position of 203 patients admitted to hospital with complaints of lower back pain were studied. Medial sagittal slices of the lumbar spine were imaged from L1 to S1. LDH is classified as either bulging, extrusion, or protrusion., Results: For this study, 83 males and 120 females with a mean age of 43.18 ± 14.68 years were recruited. The highest herniation level was observed at L4-L5 in 145 (71.4%) patients: 76 instances of disc bulging (37.4%), 56 instances of extrusion (27.6%), and 13 instances of protrusion (6.4%). The longest distance between the skin and spinal cord was 60.06 ± 1.61 mm at L5-S1; the longest distance at width of the epidural space was 6.09 ± 1.95 mm at L3-L4. According to the disc herniation groups, no significant differences were found between the skin-to-dura distance, width of the epidural space, and depth of skin level to spinous process ( P > 0.05). Moreover, the anterior dura to cord distances was significantly different from normal patients ( P < 0.05). Indeed, there was a statistically weak and negative correlation between both the length and age of the lumbar spinal canal ( P < 0.05, r = -0.295)., Conclusions: Lumbar disc pathologies can cause anatomical derangements in the spinal canal, which may cause neurologic deficits by neuraxial blockade., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Anesthesia: Essays and Researches.)

Ectopic intrathoracic liver tissue is extremely rare. Studies are mainly limited to case reports. In the vast majority of reported cases, a diagnosis of intrathoracic liver tissue was made either after a thoracic surgery or during a postmortem examination. However, once included in differential diagnosis, surgical intervention or biopsy procedures may be avoided with optimal diagnostic approach. In the present study, we conducted a literature review and proposed a new classification method for accessory liver within the thoracic cavity. This approach may provide a better understanding of underlying pathophysiology and aid in determination of optimal diagnostic modality and clinical management of such cases. According to our literature review, type II ectopic liver is the most common subtype followed by types I and III. All types can be definitively diagnosed with imaging modalities. On the other hand, it is important to prevent patients, particularly children, from unnecessary radiation exposure during performance of sophisticated diagnostic imaging modalities. Ultrasound is a safe, low-cost and accessible imaging modality that has not been previously reported in diagnosis of this entity. With addition of Color Doppler Imaging, ultrasound may allow for diagnosis with high precision in types I and II, as demonstrated in the present study. Based on long-term follow-up of a case reported here, this study also illustrates the natural course of this entity via non-operative management. This approach may prevent an unnecessary surgical intervention.

Purpose: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region., Material and Methods: 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study., Results: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%)., Conclusion: Findings suggestive of diaphragmatic rupture must be carefully evaluated in patients with blunt or penetrating thoracoabdominal trauma., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The aim of this study is to show the frequency of incidentally found (pulmonary thromboembolism) PTE in oncological patients and evaluate dispersion of incidents in terms of underlying primary tumor and seek risk factors associated with incidental PTE. Among one thousand oncology patients, 46 (4.6%) individuals found to have incidental PTE. Of positive patients, the highest proportion (24%) was belong to breast cancer group (n=11). The most common location for pulmonary emboli was the lower lobe branch of right pulmonary artery (n=33, 71.7%). Evident PTE had not been reported in final radiology reports of 21 cases., (Copyright © 2016 Elsevier Inc. All rights reserved.)