Multiple renal angiomyolipomas with asymptomatic nontraumatic pulmonary fat embolus: A case report

Although retroperitoneal bleeding and massive hematuria are potential complications of angiomyolipoma (AML), the pulmonary embolism as a presenting symptom is extremely rare. It is important to be aware that benign AMLs can present with pulmonary fat embolism.

A rare case of giant mediastinal thymolipoma in an 18-year man

Thymolipoma is a rare benign thymic lesion that can manifest as a sizable anterior mediastinal mass. Considering their rarity and challenging preoperative diagnosis, it is crucial to consider these tumors when dealing with anterior mediastinal masses.

Comparison of the intima-media thickness of the common carotid artery in patients with rheumatoid arthritis: A single-center cross-sectional case-control study, and a brief review of the literature

Background and Aim

Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease affecting 0.5%-1% of adults worldwide. The carotid intima-media thickness (CIMT) is a simple, reliable, noninvasive marker for subclinical atherosclerosis. The aim of this study was to compare the intima-media thickness of the common carotid artery in patients with RA with that of healthy patients.

Methods

In this case-control study, subjects were recruited from the patients who presented to a private rheumatology clinic. RA was documented by a rheumatologist. All subjects underwent an ultrasound examination of the carotid artery to assess CIMT. Subjects with RA filled out the disease activity score (DAS28) questionnaire.

Results

Sixty-two subjects (31 subjects with RA and 31 healthy subjects) took part in the study. The mean age of the subjects in the RA and the control groups was 42.39 ± 12.98 and 44.48 ± 13.56 years, respectively. Values of CIMT were significantly greater in RA subjects compared with their healthy counterparts (p < 0.001). The CIMT increased significantly with increased disease severity (r = 0.73). Subjects were divided into two age groups (≤40 and >40 years). A comparison of CIMT in the mentioned subgroups revealed a remarkable difference in CIMT values between those of the RA patients and those of their control counterparts in both age groups (p = 0.002 and p < 0.001 for those below and above 40 years, respectively).

Conclusion

CIMT could be used as an efficient clinical index for identifying the early stages of atherosclerosis and predicting cardiovascular events following atherosclerosis in RA patients.

Differentiating benign and malignant thyroid nodules: A cross-sectional study on the comparison of diagnostic value of ultrasound elastography and fine needle aspiration biopsy

Background and Aim

This study examines the comparison of ultrasound elastography and fine needle aspiration (FNA) in diagnosing thyroid cancers and investigates the use of elastography as the initial diagnostic test of thyroid cancers to avoid the need for invasive diagnostic tests.

Methods

In this study, 28 patients with 48 thyroid nodules (TNs) who were candidates for FNA or surgery were examined within a period of 18 months. Cut-off and subsequently sensitivity and specificity for elastography results, compared to pathology results as the gold standard, were calculated using the receiver operating characteristic curve (ROC).

Results

Based on ROC, the cut-off point differentiating the tissue stiffness between benign and malignant TNs was 25.400 kilopascal (kPa) (sensitivity of 90.9% and specificity of 78.4%). It was observed that age affects the tissue stiffness; therefore, the cut-off was defined as 65.625 kpa for age groups under 50 years old (sensitivity of 100% and specificity of 100%) and 25.400 kpa for the age group above 50 years old (sensitivity of 88.9% and specificity of 70.4%).

Conclusion

Based on the high sensitivity and specificity of shear wave elastography in the differentiation of benign and malignant TNs, it can be employed as a stand-alone or in combination with other diagnostic techniques to reduce the need for inessential surgical operations. However, future studies or developments are needed on this promising diagnostic technique.

Numerical assessment of nutrient assimilative capacity of Khur-e-Musa in the Persian Gulf

Khur-e-Musa is a predominantly tide-driven marine creek located in the northwestern part of the Persian Gulf. The port city of Mahshahr and several important industrial enterprises are located in the vicinity of this marine creek. Therefore, marine pollution due to discharge from regional industries into this water body has been a matter of interest for environmental studies. In this paper, nutrient assimilative capacity of the Khur-e-Musa during the summer time was studied. In order to perform any engineering project or marine environment study related to Khur-e-Musa, the prediction of currents is an essential task. Therefore, MIKE 3-FM hydrodynamic and quality model was used to simulate nutrients and chlorophyll a concentrations. OECD open boundary index was used to determine the trophic status probabilities. Different scenarios were defined and simulated to find the minimum nutrient load that causes eutrophication in all parts of Khur-e-Musa simultaneously. The results showed assimilative capacity of 7,180 kg/day TN and 1,305 kg/day TP for Khur-e-Musa.