Search

Our study aimed to evaluate clinical, functional, and prognostic features and to determine the prognosis of idiopathic pulmonary fibrosis, connective tissue disease-associated interstitial lung diseases, and interstitial pneumonia with autoimmune features.Sixty-nine cases with interstitial lung diseases were recruited in this study prospectively. Demographic features, symptoms, radiological findings, functional measurements, and immunological markers were recorded twice (at the time of initial admission and in the 12th month). Twenty-four of 69 cases were idiopathic pulmonary fibrosis, 32 were connective tissue diseaseassociated interstitial lung diseases, and 13 were interstitial pneumonia with autoimmune features .Most of the patients with idiopathic pulmonary fibrosis were male, while there were more female patients in connective tissue disease-associated interstitial lung diseases and interstitial pneumonia with autoimmune features groups. Female patients (65.0%) predominated in connective tissue disease-associated interstitial lung diseases group (P.001). There was no significant difference in the mean ages of the disease groups, yet connective tissue disease-associated interstitial lung diseases patients were generally younger (min- max: 34-82 years). In the idiopathic pulmonary fibrosis group, only low titers of antinuclear antibody positivity were found. Antinuclear antibody positivity in the connective tissue disease-associated interstitial lung diseases group and interstitial pneumonia with autoimmune features group was high (P = .001). The long-term survival of idiopathic pulmonary fibrosis, connective tissue disease-associated interstitial lung diseases, and interstitial pneumonia with autoimmune features patients were 37%, 40 months (median) (95% CI, 5.193- 74.807), 48.6%, 80 months (median) (95% CI, 57.032-102.968), 30.8%, 46 months (median) (95% CI, 26.624-65.376), respectively.Although a consensus report describing interstitial lung diseases with autoimmune features has been published, diagnostic criteria for this group are still vague. Since the interstitial pneumonia with autoimmune features group had the worst results in terms of functional loss and survival rates, the follow-up parameters and follow-up algorithm should be established for this group. Clinical and immunological evaluation of the interstitial pneumonia with autoimmune features group should include detailed parameters because of follow-up and to estimate survival.

Objectives:To analyse the correlation between computed tomography (CT) features and histopathological findings of small lung adenocancers using the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification of Lung Adenocancer.Materials and Methods:A retrospective review of 34 nodules (size ≤2 cm) representing lung adenocancer was performed. Besides their attenuation type (solid, mixed, pure ground glass), tumours were defined as air-containing type if their vanishing ratio was ≥%50 and as solid-density type if the vanishing ratio was 0.05).Conclusion:Invasive adenocancer and NMIA lesions can be differentiated by their CT features. But greater study populations are needed for further confirmation.

Purpose: the aim of this retrospective study is to evaluate the preoperative screening performance of chest CT (computerized tomography) examination to detect COVID-19 positive individuals. Materials and methods: in this retrospective study 218 adult patients who had preoperative chest CT and RT-PCR were enrolled. CT imaging results, which have been reported according to the Radiological Society of North America expert consensus on COVID-19, were collected from the picture archiving and communicating system. Demographic data, planned surgeries, and postoperative outcomes were collected from the electronic patient records. Results: one patient (0.5%) showed typical CT features for COVID-19 pneumonia; 12 patients (5.5%) were reported as indeterminate, and eight (3.7%) were reported as atypical for COVID-19 pneumonia. Only one of the three patients with positive RT-PCR had abnormalities on CT. When RT-PCR tests were taken as reference, the sensitivity, specificity, and accuracy of chest CT in showing COVID-19 infection in asymptomatic patients were 33.3%, 90.7%, and 90.0%, respectively. Conclusion: chest CT screening for COVID-19 has a very low yield in asymptomatic preoperative patients and shows false-positive findings in 9.2% of cases, potentially leading to unnecessary postponing of the surgery., NA

It has been observed that the degree of pulmonary involvement shown in chest computed tomography (CT) scans tended to decrease as the prevalence of coronavirus disease 2019 (COVID-19) infection decreased in the Turkish population. The purpose of this study was to investigate the relationship between the disease severity based on chest CT scans and the temporal evolution of the epidemic. This study recruited 179 patients with confirmed COVID-19 disease who had received a chest CT scan between March 14 and April 28, 2020. The participants were divided into three successive temporal groups based on their date of CT examination. The early (March 14-29), mid (March 30-April 13), and late (April 14-28) groups were compared regarding the presence and extent of pulmonary involvement and CT characteristics of lesions. COVID-19 pneumonia was less extensive in participants under 45 years of age and patients presenting late in the course of epidemic (i.e., the late group) compared those presenting earlier. When each group was subcategorized on the basis of age, older patients in the late group had less extensive lung involvement than older patients in the early group. However, there was no significant difference in the extent of lung involvement in younger patients between the late and early groups. The severity of COVID-19 pneumonia appears to be variable at different temporal windows of the epidemic curve and decreases in patients presenting in the later weeks compared to the earlier weeks, particularly in older patients., NA

Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease., NA

Objective:The purpose of this study was to determine the unit cost of the main production centers of Ankara University School of Medicine Hospitals in 2008.Material and Method:Expenses and costs of the Ibni Sina and Cebeci Hospitals were obtained from the Hospital Information System and Revolving Fund distributed to the main production centers by using a step- down allocation method with three steps. Unit costs were calculated in the third allocati-on using the number of outpatients, inpatients and inpatient day.Results:The total cost of Ibni Sina Hospital (a 931-bed facility) and Cebeci Hospital (a 1153-bed faci-lity) were calculated as 117.994.696,14 TL and 106.378.973,80 TL respectively. In Ibni Sina Hospital, the average unit costs of outpatient clinics are higher in the departments of internal medicine compared to the departments of surgery. In terms of inpatient days, the avarage unit costs of departments of surgery is higher than the departments of internal medicine. In Cebeci Hospital, it is determined that the avarage unit costs of outpatient clinics are higher in the departments of surgery compared to the departments of internal medicine whereas the reverse is true for inpatient clinics.Conclusion:Being aware of unit costs in a large-size hospital would improve strategic decision-ma-king process including effective financial management, healthcare service planning and human reso-urces management.

Amac: Bu calismada Ankara Universitesi Tip Fakultesi Hastaneleri’nin 2008 yili verilerine gore hastane esas uretim merkezlerindeki birim maliyetlerin belirlenmesi amaclanmistir. Gerec ve Yontem: Hastane Bilgi Sistemi ve Doner Sermaye Isletme Mudurlugu’nden temin edilen Ankara Universitesi Hastaneleri’ne (Ibni Sina Hastanesi ve Cebeci Hastanesi) ait harcama ve giderler uc dagitim asamasindan olusan kademeli dagitim yontemi kullanilarak esas uretim gider yerlerine da- gitilmistir. Birim maliyetler, poliklinik sayisi, yatan hasta sayisi ve yatilan hasta gunu sayisi kullanilarak ucuncu dagitimda hesaplanmistir. Bulgular: Ibni Sina Hastanesi’nin (931 yatakli) toplam maliyeti 117.994.696,14 TL, Cebeci Hastanesi’nin (1153 yatakli) toplam maliyeti 106.378.973,80 TL olarak saptanmistir. Ibni Sina Hastanesi’nde dahili tip bilim dallarinin poliklinik ortalama birim maliyetlerinin, cerrahi tip bilim dallarina oranla daha yuksek oldugu belirtilmistir. Klinik ortalama birim maliyetleri acisindan yatan hasta sayisina gore dahili tip bilim dallarinin ortalama birim maliyetlerinin daha yuksek oldugu; yatilan gun sayisina gore ise cerrahi tip bilim dallarinin ortalama birim maliyetlerinin daha yuksek oldugu saptanmistir. Cebeci Hastanesi’nde, poliklinik ortalama birim maliyetleri acisindan cerrahi tip bilim dallarinin dahili tip bilim dallarina oranla daha yuksek oldugu; klinik ortalama birim maliyetlerinde ise dahili tip bilim dallarinin daha yuksek oldugu tespit edilmistir. Sonuc: Buyuk kapasiteli hastanelerin birim maliyetlerinin bilinmesi, finansal yonetim, saglik hizmetleri planlamasi ve insan kaynaklari gibi konularla ilgili stratejik karar alma surecinin etkili bir sekilde ger- ceklestirilmesini saglayacaktir.

Two cases of incidentally detected aneurysms involving the portal venous system are described with emphasis on gray-scale and color Doppler ultrasonographic (US) findings. Appearing on US as anechoic masses showing direct luminal continuity with the right portal vein and superior mesenteric vein, the lesions displayed spectral findings characteristic of portal venous system on color Doppler US. Dynamic helical computed tomography (CT) demonstrated simultaneous enhancement with the portal system, while the aneurysms were hypointense owing to flow void on T1-weighted spin-echo magnetic resonance (MR) images.

SUMMARY A 40 year old woman who was pre-operatively diagnosed as possibly having adrenal myelolipoma is reported. Adrenal myelolipomas are rare, non-functional benign tumours comprising varying amounts of fat and haematopoietic elements. Albeit possibly coincidental, there is a frequent association with obesity, hypertension, and/or diabetes mellitus. A growing number of patients are being diagnosed during ultrasonographic or computerized tomographic scanning for unrelated problems.

A comparative prospective study of technetium-99m methoxyisobutylisonitrile (MIBI) and thallium-201 with early (15 min) and delayed (90 min for MIBI, 3 h for 201Tl) imaging in the differentiation of thyroid lesions is presented. Forty patients with cold thyroid nodules visualised on 99mTc-pertechnetate scan and with dyskaryotic or atypical epithelial cells verified by fine needle aspiration biopsy underwent MIBI and 201Tl scintigraphy at 3-day intervals. Subsequent thyroidectomies were carried out in all patients. Semiquantitative analysis was performed using a lesion to non-lesion ratio on early (ER) and delayed images (DR). Additionally, a retention index (RI) was calculated using the formula RI=(DR-ER) x 100/ER. The reproducibility of the method for the early and delayed measurements was tested by analysing intra- and inter-observer variability and repeatability coefficients. Histopathologically, the nodules were found to be well-differentiated thyroid cancer in 21 patients and benign in 19 patients. There was no significant difference in the ER between malignant and benign lesions for either 201Tl or MIBI (P0.05). However, for both agents significant differences were found between malignant and benign lesions with regard to DR (P0.01 for 201Tl and P0.001 for MIBI) and RI (P0.001 for both agents). Statistical comparison of the two agents showed no significant differences (P0.05) except with regard to DR and RI in malignant nodules (P0.05). A receiver operating characteristic analysis was performed to determine threshold levels for the differentiation of malignant from benign nodules. Following this analysis, ER, DR and RI levels of 1.03, 1.54 and 2 for MIBI andor =1.42, 1.24 and 5 for 201Tl were selected. Using these threshold levels, the sensitivity, specificity and accuracy of the study were 90.5%, 36.8% and 65% for ER MIBI, 61.9%, 94.7% and 77.5% for DR MIBI, 95.2%, 89.4% and 92.5% for RI MIBI, 85.7%, 47.3% and 67.5% for ER 201Tl, 80.9%, 73.6% and 77.5% for DR 201Tl, and 90.5%, 94.7% and 92.5% for RI 201Tl. In conclusion, the DR for MIBI and 201Tl is superior to the ER in detecting malignant nodules, and the RI for both MIBI and 201Tl is more valuable than the DR in differentiating malignant from benign thyroid nodules.