Accurate Diagnostic Assessment Research Articles

Clinicopathological and Radiological Correlation Among the Spectrum of Nodular Thyroid Lesions.

Objective The primary objective of this study is to comprehensively evaluate nodular thyroid lesions. By analyzing the morphological characteristics of surgically resected specimens and biopsies, the aim is to establish correlations between the patterns, corresponding clinical diagnoses and radiological findings. Furthermore, the study will investigate cases where there is a discrepancy between imaging and pathological assessments, with the goal of understanding the contributing factors to this discordance and improving diagnostic accuracy. Methodology This retrospective observational study utilized convenience sampling to recruit participants. Sample size was determined using GPower software (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany).Statistical analysis was performed using Jamovi 2.3.28 (Jamovi Research, Vienna, Austria).The Chi-square test was employed to assess the association between the Thyroid Imaging Reporting and Data System (TIRADS) score and histopathological diagnosis.Receiver operating characteristic (ROC) analysis was conducted to identify the optimal TIRADS cut-off point for classifying nodules as malignant and to evaluate the diagnostic accuracy of TIRADS.Discordant cases between histopathological and radiological findings were analyzed to investigate potential discrepancies. Result Taking into consideration histopathology report as a gold standard, correlation of TIRADS with histopathology findings, TIRADS showed 73.08% sensitivity and 81.08% specificity, showing the strongest balance between sensitivity and specificity, as demonstrated by the Youden's Index and Metric Score. The area under the curve (AUC) remains constant at 0.805, suggesting a consistent overall discriminative ability of the TIRADS scale. Conclusion A primary advantage of this study is its exclusive focus on surgically resected nodules, which allows for definitive histological confirmation and thereby ensures the most accurate diagnostic assessment.

Approach and barriers to the assessment and treatment of individuals with co-occurring OCD and PTSD: Treatment providers’ perspectives

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) frequently co-occur, and phenotypic and functional similarities between the disorders necessitate assessment and treatment considerations by providers. To date, no research has reported on mental health treatment providers’ approach to, and barriers associated with, assessing and treating patients with this complex comorbidity. The present study included 169 mental health providers, the majority of whom were cognitive behaviorally-oriented specialists who had recently treated co-occurring OCD and PTSD. Having a doctorate degree and overall years of experience predicted greater perceived competence to assess and conceptualize co-occurring OCD and PTSD. Recent clinical experience with co-occurring OCD and PTSD predicted perceived competence to conceptualize and treat individuals with both disorders. PTSD specialists perceived themselves as more competent to treat co-occurring OCD and PTSD than non-PTSD specialists. Most providers indicated some barriers to adequate assessment and treatment of individuals with co-occurring OCD and PTSD, including competing priorities and lack of time. Implications of findings are discussed within the context of future training targets to equip providers with the tools needed to conduct comprehensive and accurate diagnostic and functional assessment, as well as provide evidence-based treatment tailored to the unique needs of individuals with co-occurring OCD and PTSD.

Optical coherence tomography biomarkers in early and intermediate age-related macular degeneration: A clinical guide.

Advanced forms of age-related macular degeneration (AMD), characterised by atrophic and neovascular changes, are a leading cause of vision loss in the elderly population worldwide. Prior to the development of advanced AMD, a myriad of risk factors from the early and intermediate stages of AMD have been published in the scientific literature over the last years. The ability to precisely recognise structural and anatomical changes in the ageing macula, altogether with the understanding of the individual risk implications of each one of them is key for an accurate and personalised diagnostic assessment. The present review aims to summarise updated evidence of the relative risk conferred by diverse macular signs, commonly seen on optical coherence tomography, in terms of progression to geographic atrophy or macular neovascularization. This information may also serve as a basis for tailored follow-up monitoring visits.

Definition of malnutrition from routinely-collected data for orthopedic surgery research: the global leadership initiative on malnutrition (GLIM) tool and others.

The correct identification of malnourished patients in the context of hip, knee, or spine surgery research would enhance the quality of analytical studies investigating the prediction potential of preoperative nutritional disorders on postoperative recovery. However, accurate malnutrition screening and diagnostic assessment rely on parameters that were not routinely collected in routine practice until a few years ago. The authors of this article present substitute literature-based equations that can be built up using historical routinely collected data to classify patients that had been at risk of malnutrition or malnourished. For what concerns the risk screening, several methods are available to identify patients at risk of over- or undernutrition, encompassing the BWd (body weight difference from the ideal weight), GNRI (geriatric nutritional risk index), INA (instant nutritional assessment), LxA (combination of lymphocyte count and albumin), PMA (protein malnutrition with acute inflammation), PMAC (protein malnutrition with acute and chronic inflammation), IDM (iron deficit malnutrition), and VBD (vitamin B deficit malnutrition). Conversely, the GLIM (global leadership initiative on malnutrition) criteria can be used to assess malnutrition and diagnose subclasses of undernutrition. Rational use of these tools can facilitate the conduction of efficient prospective studies in the future, as well as bespoke retrospective cohort studies and database research.

Towards cost-effective and lightweight surface plasmon resonance biosensing for H5N1 avian influenza virus detection: Integration of novel near-infrared organic photodetectors

H5N1 avian influenza virus (AIV) persists in causing highly fatal human infections, demanding rapid and accurate diagnostic assessment. In this study, we introduce an intensity-based SPR sensor utilizing NIR wavelength excitation in tandem with a specifically engineered NIR-OPD. The active layer of the OPD consists of a PTB7-Th and COTIC-4 F blend, offering an optimized response for a 980 nm excitation wavelength. Key performance metrics of this OPD include a low Jd of 0.185 nA/cm2, a high responsivity of 0.35 A/W, an EQE of 44.74%, and an exceptional detectivity of 4.59 × 1013 Jones at 980 nm wavelength under zero bias. It also exhibits a wide LDR of 113 dB. The integration of such OPDs into our SPR sensor provides advantages in compactness and cost-effectiveness. Employing this sensor, we detected the H5N1 AIV using a custom high-affinity polyclonal antibody against HA envelope of the H5N1 virus, completing analyses of culture medium samples within 12 min. The detection limit of this biosensor for the H5N1 AIV in PBS-diluted culture medium is approximately 4.3 × 104 copies/mL. When compared to a commercial H5-Ag lateral flow test kit, our biosensor showed a sensitivity 37 times higher. Key attributes of our biosensor include 3D printing technology for easy alignment of optical components and a rapid, simplified detection procedure. Collectively, our findings open up the potential of our SPR biosensor as an efficient tool for detecting H5N1 AIV, promising advancements in on-site detection methodologies.

Prevalence of myositis specific and associated antibodies in a cohort of patients affected by idiopathic NSIP and no hint of inflammatory myopathies.

The presence of interstitial lung disease (ILD) is a common and fearsome feature of idiopathic inflammatory myopathies (IIM). Such patients show radiological pattern of non-specific interstitial pneumonia (NSIP). The present study aimed to assess the prevalence of myositis-specific and myositis-associated antibodies (MSA and MAA) in a cohort of patients with a previous diagnosis of NSIP and no sign or symptom of IIM. Secondly, it will be assessed whether patients displaying MSA and/or MAA positivity have a worse or a better outcome than idiopathic NSIP. All patients affected by idiopathic NSIP were enrolled. MSA and MAA were detected using EUROLINE Autoimmune Inflammatory Myopathies 20 Ag (Euroimmun Lubeck, Germany), line immunoassay. A total of 16 patients (mean age 72 ± 6.1years old) were enrolled. Six out of 16 patients (37.5%) had significant MSA and/or MAA positivity: one displayed positivity of anti-PL-7 (+ +), one of anti-Zo (+ +), anti-TIF1γ (+ + +) and anti-Pm-Scl 75 (+ + +), one of anti-Ro52 (+ +), one of anti-Mi2β (+ + +), one of anti-Pm-Scl 75 (+ + +) and the latter of both anti-EJ (+ + +) and anti-Ro52 (+ + +).Two out of 7 seropositive patients showed a significant impairment of FVC (relative risk 4.8, 95% CI 0.78-29.5; p = 0.0350). Accordingly, among the 5 patients that started antifibrotic treatment during the observation time, 4 were seronegative. Our findings highlighted a potential autoimmune or inflammatory in idiopathic NSIP patients and also in those without significant rheumatological symptoms. A more accurate diagnostic assessment may ameliorate diagnostic accuracy as well as may provide new therapeutic strategy (antifibrotic + immunosuppressive). A cautious assessment of NSIP patients with a progressive and non-responsive to glucocorticoids disease course should therefore include an autoimmunity panel comprising MSA and MAA.

The Detection of Dental Pathologies on Periapical Radiographs-Results from a Reliability Study.

(1) Background: Caries, periapical lesions, periodontal bone loss (PBL), and endo-perio lesions are common dental findings that require an accurate diagnostic assessment to allow appropriate disease management. The purpose of this reliability study was to compare the inter- and intra-rater reliability for the detection of the above-mentioned pathologies on periapical radiographs. (2) Methods: Fourteen dentists (three with more than two years and eleven with less than two years of work experience) participated in a training workshop prior to data acquisition. A total of 150 radiographs were assessed by all raters in two rounds. Cohen's Kappa (CK) values and a binary logistic regression were calculated. (3) Results: The reliability was found in a moderate and substantial range of agreement: caries (mean inter-rater CK value/first round 0.704/mean inter-rater CK value/second round 0.659/mean intra-rater CK value 0.778), periapical lesions (0.643/0.611/0.768), PBL (0.454/0.482/0.739) and endo-perio lesion (0.702/0.689/0.840). The regression model revealed a significant influence of the clinical experience, and furthermore, periapical pathologies and PBL were identified less reliably in comparison to caries and endo-perio lesions. (4) Conclusions: The dentist's ability to detect the chosen pathologies was linked with significant differences. Periapical lesions and PBL were identified less reliably than caries and endo-perio lesions.

Dual-Energy CT applications in urinary tract cancers: an update.

Urothelial tumours are the fourth most common cancer in the world and account for the majority of tumours involving the bladder. The symptom that often leads to diagnosis is the presence of haematuria. Diagnosis is made by cystoscopy, which is currently the gold standard in bladder cancer. Computed tomography (CT) performed with pre- and post-contrastographic phases is essential in order to assess the loco-regional and distant extension of disease. The diagnosis and staging of upper tract urothelial cancer (UTUC) are best done with computed tomography urography and flexible ureteroscopy (URS). In the acquisition protocol of this type of tumour, a urographic phase is mandatory, which allows for an accurate diagnostic assessment of the renal pelvis, ureter and bladder, especially in papillary forms. The use of multiple acquisition phases, especially in this type of patient who will have to perform follow-up CTs, leads to the problem of overexposure to ionising radiation, as well as the frequent administration of iodinated contrast medium. For this reason, in recent year, the focus has been put on advanced technologies such as dual-energy CT (DECT), that is a method that can offer some advantages for both radiologist and patient, in the diagnosis of cancer and, in particular, urinary tract disease.

Lower Urinary Tract Symptoms in Young Men-Causes and Management.

This review explores the subject of lower urinary tract symptoms (LUTS) in young men. Young men (aged 39 or younger) can be affected by a variety of conditions that can cause LUTS. Approximately half of young men report LUTS. Storage or "irritative" voiding symptoms are nearly twice as common as "obstructive" symptoms in young men. Infectious or inflammatory causes such as prostatitis are the most common cause of LUTS in this age group, while other etiologies include urethral strictures, primary bladder neck obstruction, as well as neurogenic and non-neurogenic bladder dysfunction. A thorough clinical evaluation is critical for determining the correct diagnosis and directing the appropriate treatment plan. Young men experience lower urinary tract symptoms at relatively high rates. Clinical treatments range from behavioral therapy to medications and/or surgical interventions. Ambulatory urodynamics and wearable sensors may provide more accurate and real-world diagnostic assessment of bladder dysfunction in this relatively under-studied group. More study is needed to characterize the disease burden and impact in this specific group of patients.

Hypertension, hypotension and syncope.

Hypertension and hypotension are strictly related phenomena, that frequently coexist within the spectrum of cardiovascular autonomic dysfunction, especially at advanced age. Indeed, antihypertensive treatment may predispose to orthostatic and postprandial hypotension, while intensive blood pressure lowering may be responsible for systemic hypotension. Over recent years, systemic and orthostatic hypotension have emerged as important although often neglected risk factors for adverse outcomes, paralleling the widely recognized arterial hypertension. Both hypertension and hypotension are associated with detrimental effects on target organs and survival, thus significantly impacting patients' prognosis, functional autonomy, and Quality of Life. Balancing low and high blood pressure requires accurate diagnostic assessment of blood pressure values and patients' hypotensive susceptibility, which allow for the development of customized treatment strategies based on individual hypo/hypertensive risk profile. The present review illustrates the complex interrelationship between hypotension and hypertension and discusses the relevant prognostic role of these conditions. Additionally, it provides an overview on hypotension detection and treatment in patients with hypertension, focusing on customized diagnostic and therapeutic strategies.

Evaluation of average Frankfort mandibular plane angle in West Rajasthan population

Introduction: The relationship between the malocclusion and the facial form has been a focus for Orthodontists since the early 20th century. Cephalometrics can be utilized to describe, compare and classify the nature of orthodontic problems. Since well-established Indian ethnic norms are lacking, norms derived for Caucasian population are routinely used for investigations. Rajasthan is one of the largest state in India and Mewar is one of the major areas of it. With the increasing number of children of Rajasthan seeking professional treatment for malocclusion, it has become apparent that there is need to determine what constitutes a pleasing or normal face for the children of Rajasthan. A comprehensive and accurate diagnostic assessment of any orthodontic patient involves the comparison of the patient’s cephalometric findings with the norms of his or her ethnic groups or racial groups or subgroups. Materials and Methods: This study was conducted on 100 lateral cephalographs which were selected from the records in the Department of Orthodontics and Dentofacial Orthopedics. Results: According to results there was a higher FMPA in males than females in Western Rajasthan population. While observing the overall result no significant difference was observed in FMPA between male and female population of Western Rajasthan. Conclusion: The present study was undertaken to develop cephalometric norms of Tweed’s diagnostic facial triangle for West Rajasthan population and to find out any variation from Caucasian standard. The result of the study indicated that separate norms should be considered forWest Rajasthan males and females during diagnosis and treatment planning. Keywords: Frankfort mandibular plane, Caucasian, Rajasthan.

Graves' orbitopathy: a multidisciplinary approach.

Orbitopathy is the main extra thyroidal manifestation of Graves' disease. It is a very challenging condition, which requires a cooperation between many specialists (endocrinologists, ophthalmologists, radiologists, radiotherapeutic, orbital surgeons) for an optimal clinical management. An accurate diagnostic assessment is required, in order to plan an adequate treatment of Graves' orbitopathy. Medical therapy, radiotherapy or surgery may be necessary to control the disease. In this review, the authors analyze the various therapeutic strategies, as well the more recent therapies based on pharmacologic immunomodulation.

Importance of pre-operative ultrasound examination and pathological tumour evaluation in the management of women with endometrial cancer

IntroductionEndometrial cancer (EC) is the most common gynaecological malignancy in developed countries. Early and accurate diagnostic assessment is crucial for appropriate treatment planning. Information obtained by pre-operative imaging with transvaginal ultrasound (TVUS) and histological endometrial biopsy assessment is often the cornerstone for further management planning. This study aimed to analyse the accuracy of this diagnostic approach for patient management decisions. Materials and methodsThis single-centre retrospective analysis included all patients with endometrial cancer treated between 2015 and 2019. Pre-operative TVUS staging assessment and histopathological endometrial biopsy examination were compared with the final surgical stage and histopathological diagnosis. ResultsPre-operative and surgical pathological assessment of Type I and Type II tumours was in agreement in 95 % (174/184) and 54 % (12/22) of cases, respectively. The sensitivity and specificity of TVUS assessment of myometrial invasion were 76 % [95 % confidence interval (CI) 66.3–84.2 %] and 81.7 % [95 % CI 73.0–88.6 %], respectively. Diagnostic accuracy was higher for Type I EC (95 %) than Type II EC (54 %). Only presumed ESMO/ESGO/ESTRO risk classification (p < 0.000) and deep myometrial invasion (p < 0.000) were significant for the prediction of lymph node involvement. ConclusionPre-operative TVUS examination and pathological endometrial biopsy evaluation enable moderately accurate assessment of the risk of EC. Efforts should be aimed towards the development of novel and more reproducible methods, such as molecular tumour characterization, to improve the pre-operative assessment of risk in patients with EC.

Detection of HPV16/18 E6 Oncoproteins in Head and Neck Squamous Cell Carcinoma Using a Protein Immunochromatographic Assay.

The accurate diagnostic assessment of clinically relevant human papillomavirus (HPV) infections in patients with head and neck squamous cell carcinoma represents an urgent unmet medical need. The aim of this study was to determine feasibility, accuracy, and clinical significance of HPV16/18 E6 oncoprotein detection on cytological specimens from oropharyngeal squamous cell carcinoma (OPSCC) and neck lymph node metastasis of SCC from unknown primary tumor (CUP) via a protein immunochromatographic assay. Cross-sectional study. Cytological specimens from primary tumor and neck metastases were collected from 34 patients with OPSCC or CUP and applied to a lateral flow format test that detects HPV16 and HPV18 E6 oncoproteins. E6 oncoprotein positivity or negativity in these specimens was compared to the specimens' "HPV-driven" reference status, defined by presence of HPV-DNA in combination with p16INK4a overexpression and/or HPV E6 seropositivity. Eighteen of 29 OPSCC (62%) and three of five CUP (60%) were HPV-driven according to our reference method. The E6 oncoprotein lateral flow test had a sensitivity of 94% (95% CI: 70%-100%) and a specificity of 100% (95% CI: 66%-100%) on primary tumor, and a sensitivity of 88% (95% CI: 64%-99%) and a specificity of 100% (95% CI: 74%-100%) on neck metastases. Test agreement between the E6 lateral flow test and the clinical reference method, HPV-DNA plus p16INK4a was excellent, both for primary lesion and neck metastases. We found the detection of HPV16/18 E6 oncoproteins to be a feasible, highly reliable, and low-invasive method to assess "HPV-driven" status in OPSCC and CUP. II Laryngoscope, 131:1042-1048, 2021.

Established paths and new avenues: a review of the main radiological techniques for investigating sarcopenia.

Sarcopenia is a clinical condition mainly affecting the elderly that can be associated in a long run with severe consequences like malnutrition and frailty. Considering the progressive ageing of the world population and the socio-economic impact of this disease, much effort is devoted and has to be further focused on an early and accurate diagnostic assessment of muscle loss. Currently, several radiological techniques can be applied for evaluating sarcopenia. If dual-energy X-ray absorptiometry (DXA) is still considered the main tool and it is even recommended as reference by the most current guidelines of the European working group on sarcopenia in older people (EWGSOP), the role of ultrasound (US), computed tomography (CT), peripheral quantitative CT (pQCT), and magnetic resonance imaging (MRI) should not be overlooked. Indeed, such techniques can provide robust qualitative and quantitative information. In particular, regarding MRI, the use of sequences like diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS) and mapping that could provide further insights into the physiopathological features of sarcopenia, should be fostered. In an era pointing to the quantification and automatic evaluation of diseases, we call for future research extending the application of organ tailored protocols, taking advantage of the most recent technical developments.

Personality disorder in an Early Intervention Psychosis cohort: Findings from the Social Epidemiology of Psychoses in East Anglia (SEPEA) study.

AimPersonality Disorders (PD) often share clinical and phenomenological overlap with psychotic disorders, especially at onset. However, there is little research on comorbid PD among people experiencing first episode psychosis. We examined the prevalence of PD recording and its sociodemographic and clinical correlates in people accepted to Early Intervention in Psychosis (EIP) services.MethodsParticipants were aged 16–35, accepted into 6 EIP services for suspected psychosis, as part of the Social Epidemiology of Psychoses in East Anglia (SEPEA) study. PD was recorded by clinicians according to ICD-10. Multilevel logistic regression was performed.ResultsOf 798 participants, 76 people (9.5%) received a clinical diagnosis of PD, with emotionally unstable PD (75.0%, N = 57) the most common subtype. In multivariable analysis, risk factors for PD included female sex (odds ratio [OR]: 3.4; 95% CI: 2.0–5.7), absence of psychotic disorder after acceptance to EIP (OR: 3.0; 95% CI: 1.6–5.5), more severe hallucinations (OR: 1.6; 95% CI: 1.2–2.1), and lower parental SES (OR: 1.4; 95% CI: 1.1–1.8). Compared with the white British, black and minority ethnic groups were less likely to receive a PD diagnosis (OR: 0.3; 95% CI: 0.1–0.7). There was no association between PD and neighbourhood-level deprivation or population-density.ConclusionsRecording of a PD diagnosis was three times more common amongst participants later found not to meet threshold criteria for psychotic disorder, implying phenomenological overlap at referral which highlights difficulties encountered in accurate diagnostic assessment, treatment and onward referral. People with PD experienced more individual-level, but not neighbourhood-level social disadvantage in an already disadvantaged sample.

A unique temporary collateral pathway between carotid-vertebrobasilar arteries in a carotid dissection patient

BackgroundIn adults, the anastomosis between carotid and vertebrobasilar arteries is usually the posterior communicating artery, sometimes the primitive trigeminal artery. In this case, the basilar artery fed the internal carotid artery through the pontine-to-tentorial artery anastomosis after severe stenosis from traumatic carotid dissection.Case presentationA 32-year-old female was diagnosed with ischemic stroke caused by traumatic carotid artery dissection. Aspirin (100 mg/day) and clopidogrel (75 mg/day) were prescribed. Digital subtraction angiography performed 6 days after stroke onset showed a dissection in the cervical segment of left internal carotid artery with severe local stenosis, and a collateral pathway from BA to the cavernous segment of internal carotid artery through the lateral pontine and tentorial artery. Without interventional therapy, clinical symptoms improved significantly within 10 days after onset. At 3-month follow-up, left common carotid artery angiography showed the stenosis had been significantly improved with a residual aneurysm. There was no collateral pathway between carotid-vertebrobasilar arteries, and a residual small artery originated from the posterior vertical segment of cavernous internal carotid artery. The small artery was clearly visualized by 3-dimensional rotational angiography and identified the tentorial artery.ConclusionTo the author’s knowledge, this is the first report of a collateral pathway between carotid vertebrobasilar arteries through the pontine-to-tentorial artery anastomosis. Meanwhile, tentorial artery origination directly from the cavernous segment of internal carotid artery is rare and easily mistaken for persistent primitive trigeminal artery. 3-dimensional rotational angiography can provide sensitive and accurate diagnostic assessment of the small artery, and may be a useful tool for screening of abnormal small arteries.

Abstract TP89: Absolute Cerebral Blood Flow Assessment With Novel Low-Dose Whole Brain Dynamic CT Perfusion Technique

Purpose: Existing CT perfusion (CTP) techniques are limited in accurate assessment of stroke. The purpose of this study is to validate a novel low-dose whole-brain first-pass analysis (FPA) technique as compared with gold standard microsphere measurement in a swine model. Materials and Methods: Contrast-enhanced CTP of 5 Yorkshire swine (55 ± 24 kg) was performed over 30 seconds at baseline and following incremental brain embolization. For each acquisition, gold standard fluorescent microspheres, IV contrast, and saline were injected (5 ml/s), followed by dynamic CTP imaging in a 320-slice CT scanner. Scan parameters were 320 x 0.5 mm collimation, 100 kVp, 200 mA, and 350 ms gantry rotation time. On average, 47 contrast-enhanced volume scans were acquired per acquisition to capture the entire time attenuation curve (TAC) of the carotid artery. For each acquisition, only two retrospectively selected volume scans were used to quantify brain perfusion with the low-dose FPA technique. Specifically, the first volume scan was selected at the base, while the second volume scan was selected at the peak of the TAC. Regional low-dose FPA CTP measurements from different lobes were then quantitatively compared to gold standard microsphere perfusion of corresponding tissue samples by using linear regression and Bland-Altman analysis. The CT dose index (CTDI) and dose-length product (DLP) of two-volume FPA technique were also determined. Results: Low-dose FPA perfusion measurements (P FPA ) were related to gold standard microsphere perfusion measurements (P MICRO ) by P FPA = 1.14 P MICRO - 0.01 (r = 0.93, p &lt; 0.01). The CTDI and DLP per two-volume FPA CTP were estimated to be 25.6 mGy and 409.6 mGy, respectively. Conclusion: Low dose FPA CTP technique was retrospectively validated in a swine model and has the potential to be used for accurate diagnostic assessment and follow up of patients with stroke and vasospasm.

Screening for depression among geriatrics in the rural community, Gharbia Governorate, Egypt

Background Depression is a common and serious medical illness that negatively affects feeling, the way of thinking, and acting. The quick increment in the elderly population has engendered public concern about the issues associated. Elderly people who have symptoms of depression are at a very high chance for useful incapacity and have an incredible requirement for accurate diagnostic assessment. Aim The paper aims to screen for depression among the geriatric age group in the rural setting, Egypt. Patients and methods Geriatrics aged 60 years and older were the target population of the study. A cross-sectional study was used to include 200 persons living in a cluster area chosen randomly from four clusters of rural area Gharbia governorate, Egypt. An assessment of depression was conducted using a validated Arab version of Geriatric Depression Scale short version. Results In total, 88.5% were suffering from various degrees of depressive symptoms. There were statistical significant associations between the occurrence of depression from one side and smoking habits, income, and absence of persons. The geriatric groups having diseases, older-age group, sleep habitat, living alone, and not received any help were considered as significant predictors for the occurrence of depression among the geriatric age group with an effect of 30.7%. Conclusion Smoking habits, income, absence of persons who introduce help for geriatrics, suffering from renal and hepatic diseases, and disability were considered significant risk factors for depression among geriatrics. Geriatric groups having diseases, older age group, sleep habitat, living alone, and not received any help were considered as significant predictors for the occurrence of depression.

Late delayed radiation-induced cerebral Arteriopathy by high-resolution magnetic resonance imaging: a case report

BackgroundRadiation therapy can cause cerebral arteriopahty, resulting in ischemic stroke. We document late-delayed cerebral arteriopathy by high-resolution magnetic resonance imaging (HR-MRI) in a middle aged man who had cranial irradiation 19 years earlier.Case presentationA 45-year-old man was diagnosed with frontal lobe glioma 19 years ago and was treated with radiation after surgical resection. He was admitted to our hospital with an acute cerebral infarction in November 8, 2017. Traditional MRI examination and HR-MRI (sagittal, reconstruction of coronal and axial) were performed at admission. He was treated with prednisone (30 mg/day) and clinical symptoms disappeared after 3 months by telephone follow-up. Our patient complained of dizziness and blurred vision and traditional MRI examination indicated acute ischemic stroke in temporal lobe and occipital lobe and microbleeds. In order to define the exact mechanism of stroke, blood tests, auto-immune screening and thrombophilia were performed and results were normal. Electrocardiography and echocardiography were negative and cardiogenic cerebral embolism was excluded. In cerebrospinal fluid (CSF) examination, level of albumin and IgG were elevated. HR-MRI showed vessel wall thickening in T1-weighted imaging, narrow lumen in proton density imaging and vessel wall concentric enhancement in contrast-enhanced T1- weighted imaging. Combined with radiotherapy history, the patient was diagnosed with radioactive vasculitis.ConclusionRadiation-induced cerebrovascular damages could be a lasting progress, which we cannot ignore. HR-MRI can provide sensitive and accurate diagnostic assessment of radiation-induced arteritis and may be a useful tool for the screening of causes of cryptogenic stroke.