Relationship between CT densitometry with a slice thickness of 0.5 mm and audiometry in otosclerosis

The appropriate cutoff Hounsfield unit (HU) value for the diagnosis of otosclerosis was determined and the correlation between the bone conduction threshold and the findings of computed tomography (CT) densitometry investigated. CT images, 0.5-mm thick, were evaluated in 24 ears with otosclerosis and 19 control ears. Eight regions of interest were set around the otic capsule. The mean HU values in the area anterior to the oval window (A-OW) and anterior to the internal auditory canal (A-IAC) were significantly lower in otosclerosis than in controls. Based on receiver operating characteristic (ROC) analysis, the cutoff HU value in A-OW was determined to be 2,187.3 HU. The mean HU value in retrofenestral otosclerosis was significantly lower in the area A-OW, A-IAC and around the cochlea than in controls. Based on ROC analysis, the cutoff HU value in the latter was determined to be 2,045 HU. A statistically significant correlation was found between the density of the area A-OW and the hearing level at 500 and 1,000 Hz, and between the density of the area around the cochlea and the hearing level at most frequencies. These results suggest the semi-automated diagnosis of otosclerosis may be possible.     

Associations between clinical findings and MRI injury extent in male athletes with acute adductor injuries — A cross-sectional study

ObjectivesTo investigate the association between clinical assessment and MRI measures of oedema and MRI grading in male athletes with acute adductor injuries.DesignCross-sectional study.MethodsWe included 81 consecutive athletes with acute adductor injuries. All athletes received a standardized clinical assessment and magnetic resonance imaging (MRI), blinded to clinical information. We analysed correlations between extent of palpation pain and extent of MRI oedema for the adductor longus. We compared the clinical assessment to MRI adductor injury grading (0?3) using ordinal regression. We analysed positive and negative predictive values (PPV/NPV) of a complete adductor longus avulsion.ResultsProximal-distal length of adductor longus palpation pain had fair correlation with MRI proximal-distal oedema length oedema (r = 0.309, p = 0.022). Cross-sectional surface area of palpation pain had poor correlation with corresponding cross-sectional MRI oedema area (r = 0.173, p = 0.208). The symptoms subscale of the Copenhagen Hip And Groin Outcome Score (HAGOS) for the period since injury (log odds ratio = 0.97, p = 0.021) and passive adductor stretch pain (log odds ratio = 0.35, p = 0.046) were associated with MRI injury grading. If there was a palpable defect, MRI always showed a complete avulsion (PPV = 100%). Several tests had high negative predictive values: passive adductor stretch (100%), palpation pain at the adductor longus insertion (98%), and the FABER test (98%).ConclusionsThe extent of palpation pain does not indicate the extent of MRI oedema in acute adductor longus injuries. A worse modified HAGOS symptoms subscale score and passive adductor stretch pain indicate a higher MRI adductor injury grade. Clinical examination tests have high ability to detect or rule out a complete adductor longus avulsion on MRI.     

儿童血清25-(OH)D水平对佝偻病诊断的意义

目的:通过对0～6岁儿童佝偻病生化标志物的检测,了解北京市亚北地区0～6岁儿童血清25羟维生素D[25-(OH)D]水平,探讨其对佝偻病诊断的意义.方法:对2010-01～2011-02本院儿科门诊就诊及查体的210例儿童,根据临床表现及体检分为佝偻病组99例和健康组111例,分别检测血清25-(OH)D水平,钙、磷、碱性磷酸酶活性,部分患儿行左腕X线摄片.结果:两组血清25-(OH)D水平比较差异有统计学意义,钙、磷、碱性磷酸酶活性比较差异无统计学意义.佝偻痛组25-(OH)D缺乏率46.5%.结论:血清25-(OH)D水平是VitD缺乏性佝偻病的可靠诊断指标,单纯依靠临床表现诊断佝偻病存在过度诊断问题,应尽可能对疑诊患儿行血清25-(OH)D水平.     

Relationship between myocardial T2* values and cardiac volumetric and functional parameters in β-thalassemia patients evaluated by cardiac magnetic resonance in association with serum ferritin levels

Purpose

Myocardial T2* cardiovascular magnetic resonance provides a rapid and reproducible assessment of cardiac iron load in thalassemia patients. Although cardiac involvement is mainly characterized by left ventricular dysfunction caused by iron overload, little is known about right ventricular function. The aim of this study was to assess the relationship between T2* value in myocardium and left–right ventricular volumetric and functional parameters and to evaluate the existing associations between left–right ventricles volumetric and functional parameter, myocardial T2* values and blood ferritin levels.

Materials and methods

A retrospective analysis of 208 patients with β-thalassemia major and thalassemia intermedia was performed (109 males and 99 females; mean age 37.7 ± 13 years; 143 thalassemia major, 65 thalassemia intermedia). Myocardial iron load was assessed by T2* measurements, and volumetric functions were analyzed using the steady state free precession sequence.

Results

A significant correlation was observed between EFLV and T2* (p = 0.0001), EFRV and T2* (p = 0.0279). An inverse correlation was present between DVLV and T2* (p = 0.0468), SVLV and T2* (p = 0.0003), SVRV and T2* (p = 0.0001). There was no significant correlation between cardiac T2* and LV–RV mass indices. A significant correlation was observed between T2* and serum ferritin levels (p < 0.001) and between EFLV and serum ferritin (p < 0.05).

Conclusion

Myocardial iron load assessed by T2* cardiac magnetic resonance is associated with deterioration in left–right ventricular function; this is more evident when T2* values fall below 14 ms. CMR appears to be a promising approach for cardiac risk evaluation in TM patients.     

Citius and longius (faster and longer) with no α‐actinin‐3 in skeletal muscles?

The muscle protein alpha-actinin-3 (ACTN3) is normally thought to be expressed in type II muscle fibres and to be necessary for high-power, high-velocity muscle contractions, such as those typically seen in speed/power athletes. The authors report the case of a Spanish elite long jumper (two times Olympian, personal best of 8.26 m) whose genotype for the ACTN3 gene is 577XX (ACTN3 deficient). These data suggest that there might be notable exceptions to the concept that ACTN3 is the "gene for speed".     

血清hs-CRP、TNF-α、25(OH)D水平与上呼吸道感染患儿的相关性分析

目的 分析血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、25-羟基维生素D[25(OH)D]水平与患儿上呼吸道感染的相关性。方法 选取我院2022年04月-2023年06月100例上呼吸道感染患儿为研究组,另选取同期200例健康体检儿童为对照组。对比两组入院时及治疗3 d、7 d时血清hs-CRP、TNF-α、25(OH)D及白细胞(WBC)、降钙素原(PCT)水平,并分析其相关性;分析入院时血清各指标联合检测对患儿上呼吸道感染的诊断价值。结果 研究组入院时血清hs-CRP、TNF-α及WBC、PCT水平均高于对照组,血清25(OH)D水平低于对照组(P<0.05);研究组入院时及治疗后血清hs-CRP、TNF-α及WBC、PCT存在显著差异,随治疗时间增加血清hs-CRP、TNF-α及WBC、PCT显著降低(P<0.05);入院时血清hs-CRP、TNF-α与WBC、PCT呈正相关,血清25(OH)D与之呈负相关(P<0.05);入院时血清hs-CRP、TNF-α、25(OH)D水平联合诊断上呼吸道感染的AUC为0.875。结论 血清hs-CR...     

系统性红斑狼疮患者外周血25(OH)D与T淋巴细胞亚群及IFN-α关系研究

目的探讨系统性红斑狼疮(SLE)患者外周血25(OH)D与T淋巴细胞亚群及α-干扰素(IFN-α)的关系。方法选取自2015年4月至2017年3月西安市第五医院风湿科收治的87例SLE患者作为SLE组,另外选择同期于我院体检中心体检的62例健康志愿者作为健康组。比较两组血清中25(OH)D、α干扰素(IFN-α)水平及T淋巴细胞亚群的表达,同时比较不同病情和维生素D水平的SLE患者血清中25(OH)D、IFN-α水平及T淋巴细胞亚群的表达情况。另外,分析SLE患者外周血中25(OH)D水平与及T淋巴细胞亚群表达及IFN-α水平的相关性。结果与健康组比较,SLE组患者血清中25(OH)D、CD3~+、CD4~+及CD4~+/CD8~+水平明显降低,而血清中IFN-α、CD8~+、Th17和Treg水平显著升高,差异均有统计学意义(P<0.05);活跃期SLE患者血清中25(OH)D、CD3~+、CD4~+及CD4~+/CD8~+水平明显低于缓解期患者,而血清中IFN-α、CD8~+、Th17和Treg水平显著高于缓解期患者,差异均有统计学意义(P<0.05);SLE患者外周血中维生素D水平下降,CD3~+、CD4~+及CD4~+/CD8~+明显降低,而IFN-α、CD8~+、Th17和Treg显著升高,差异均有统计学意义(P<0.05);SLE患者血清中25(OH)D水平与CD3~+、CD4~+及CD4~+/CD8~+呈正相关(P<0.05),而与IFN-α、CD8~+、Th17和Treg呈负相关(P<0.05)。结论SLE患者外周血中25(OH)D水平与T淋巴细胞亚群及IFN-α密切相关,其可能是通过调节T淋巴细胞亚群及IFN-α治疗SLE。     

Ultrathin needle (25 G) aspiration lung biopsy: diagnostic accuracy and complication rates

The aim of this study was to evaluate the diagnostic accuracy and complication rate of 25-G fine-needle aspiration biopsy (FNAB) of the lung in patients with suspected malignant focal lesions and abnormal lung function. The 25-G FNAB was performed in 123 patients who underwent prebiopsy CT and pulmonary function tests. Retrospective evaluation included pulmonary function, cytology, size of the lesion, depth of location, presence of emphysema on CT, needle passes, pneumothorax and drainage. The final diagnosis (gold standard) was based on histopathology after surgical resection or follow-up and response to treatment. Sixty-one patients had normal lung function or mild impairment (group 1) and 62 had moderate or severe impairment (group 2). Pneumothorax occurred in 26 of 126 procedures (20.6%) with drainage needed in 11 (8.7%). In group 2 pneumothorax occurred in 19 of 63 procedures (30.15%) with drainage needed in 11 (17.5%). The sensitivity, specificity and diagnostic accuracy of cytology results were 93.6, 100 and 94.4%, respectively. FEV1 (p=0.014), FEV1/FVC (p=0.005), FEF25—75 (p=0.001), DLCO (p=0.013) and presence of emphysema on CT (p<0.001) correlated with pneumothorax (Students t test). The 25-G lung FNAB is accurate and safe in diagnosing malignancy in patients with severe lung functional abnormality. Patients with moderate to severe airway obstruction have a higher prevalence of pneumothorax than patients with mild or no functional impairment.     

Dental and skeletal maturation as simultaneous and separate predictors of chronological age in post-pubertal individuals: a preliminary study in assessing the probability of having attained 16 years of age in the living

The goal of this paper is to explore whether combining dental and skeletal maturation data increases the reliability of determining whether an individual is 16 years old or older. This is tentatively done by building probabilistic models for age estimation based on dental and skeletal maturation using a longitudinal sample of eight males, with annual assessments between the ages of 13 and 19, totalling 56 observations. Skeletal maturity was assessed for the radius and ulna using the TW2 method, and dental maturity was assessed for the second and third molars using Demirjian’s scheme. Logistic regression was selected to determine the probability of an individual being 16 years of age and older, by combining dental and skeletal maturity scores and using them separately. The age estimation models combining dental and skeletal maturity scores seem to perform better than either dental or skeletal maturity in isolation. In addition, when in isolation or combination, models based on skeletal maturity scores seem to outperform models based on dental maturity scores. The findings seem to support the notion that dental development is less reliable than skeletal maturity for age estimation in adolescents, but these results have to be confirmed by further studies.