Clinica Terapeutica最新文献

{"title":"Diagnostic value of clinical signs for detecting temporomandibular joint disc displacement: a single-center cross-sectional diagnostic accuracy study using magnetic resonance imaging as the reference standard.","authors":"Hoang Kim Loan, Trinh Van Duy, Pham Tran Anh Khoa, Nguyen Hung Hiep, Nguyen Phu Thang, Hoang Dinh Au","doi":"10.7417/CT.2026.2115","DOIUrl":"10.7417/CT.2026.2115","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint (TMJ) internal derangement is a common cause of orofacial pain and functional limitation. Clinical symptoms such as joint pain, clicking sounds, and limited mouth opening are frequently used in the initial assessment of temporomandibular disorders (TMD). However, the diagnostic accuracy of these clinical signs in predicting disc displacement remains uncertain. Magnetic resonance imaging (MRI) is considered the gold standard for evaluating TMJ disc position and morphology. This study aimed to assess the diagnostic value of common clinical symptoms for detecting TMJ disc displacement using MRI as the reference standard.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between August 2023 and August 2024. A total of 178 patients, contributing 267 temporomandibular joints, were included. Clinical symptoms including joint pain, joint clicking, and limited mouth opening were recorded during standardized clinical examination. All participants underwent MRI evaluation of the temporomandibular joints. Disc displacement identified on MRI served as the reference standard. Because both joints of a patient could be included, observations were clustered within patients; diagnostic performance (sensitivity, specificity, PPV, NPV, accuracy, likelihood ratios, and diagnostic odds ratios with 95% confidence intervals) and multivariable generalized estimating equation models accounted for this clustering.</p><p><strong>Results: </strong>Disc displacement was present in 206 of 265 analyzed joints (77.7%). Joint pain showed the highest sensitivity (92.7%, 95% CI 88.3-95.5) but low specificity (33.9%), together with the most useful negative likelihood ratio (0.21) and the strongest discrimination (diagnostic odds ratio 6.53, 95% CI 3.08-13.86). Limited mouth opening had the highest specificity (69.5%), whereas joint clicking did not discriminate displaced from normally positioned discs (diagnostic odds ratio 1.34, 95% CI 0.74-2.42). In multivariable analysis, joint pain (adjusted odds ratio 4.06, 95% CI 1.83-9.03) and younger age were the only independent clinical predictors of disc displacement; joint effusion and condylar abnormality were additionally associated when MRI findings were included.</p><p><strong>Conclusion: </strong>Clinical symptoms provide useful preliminary information in the evaluation of TMJ disorders. However, clinical examination alone has limited diagnostic accuracy for identifying disc displacement. MRI remains the most reliable imaging modality for confirming TMJ internal derangement and should be considered when clinical findings are inconclusive.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1136-1143"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Role and Changes of a Disintegrin and Metalloproteinase with a Thrombospondin Type 1 Motif, Member 13 and Von Willebrand Factor Ag in Patients with Acute Myelogenous Leukemia.","authors":"Sajanlal Riyasat Ali, Sabiqun Nahar, Loai Emam, Mohamed Hanafy Morsy, Saeed H Halawani, Asmaa A Basonbul, Yonis Aqeel Allohibi, Mohammad Abd Elhameed Alwassef, Doaa Aly Abd El-Fattah, Nada A Bajuaifer, Esraa Adel Ahmed Ayad, Fatma M Elsayed, Mona E Hashem, Mohammed Ayad Alruqi, Ahmed Akef","doi":"10.7417/CT.2026.2117","DOIUrl":"10.7417/CT.2026.2117","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) is a hematologic malignancy associated with significant coagulation abnormalities and endothelial dysfunction. Von Willebrand factor (VWF) and its regulatory protease, a disintegrin and metalloproteinase with thrombospondin type 1 motif member 13 (ADAMTS13), play essential roles in maintaining vascular homeostasis. Disruption of this balance may contribute to thrombotic complications in AML.</p><p><strong>Methods: </strong>This case-control study included 40 newly diagnosed, untreated AML patients and 40 age- and sex-matched healthy controls recruited from Al-Azhar University Hospitals, Cairo, Egypt. Plasma VWF antigen levels and ADAMTS13 activity were measured using enzyme-linked immunosorbent assay (ELISA). Statistical comparisons between groups were performed using appropriate parametric tests, and correlation analysis was conducted to assess the association between both biomarkers.</p><p><strong>Results: </strong>AML patients showed significantly higher plasma VWF antigen levels compared with controls (274.44 ± 139.72% vs. 111.40 ± 31.77%, P < 0.001). In contrast, ADAMTS13 activity was significantly lower in AML patients than in controls (46.70 ± 29.37% vs. 99.01 ± 27.09%, P < 0.001). An inverse correlation was observed between VWF antigen and ADAMTS13 activity (r = -0.28), although this did not reach statistical significance (P = 0.08).</p><p><strong>Conclusions: </strong>Newly diagnosed AML patients demonstrate significant imbalance in the VWF-ADAMTS13 axis, characterized by elevated VWF levels and reduced ADAMTS13 activity. These findings support the presence of early endothelial dysfunction and hemostatic disturbance prior to treatment initiation. Further large-scale prospective studies are needed to determine the prognostic and clinical significance of these biomarkers.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1153-1158"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between serum Total Antioxidant Status, Malondialdehyde and Coronary Artery Disease severity: A Cross-Sectional Study.","authors":"Hoang Van, Nguyen Tien Dung, Bui Thi Thu Huong, Do Tien Anh, Hoang Hai Yen, Nguyen Thi Diep Anh","doi":"10.7417/CT.2026.2112","DOIUrl":"10.7417/CT.2026.2112","url":null,"abstract":"<p><strong>Background: </strong>Reduced Total Antioxidant Status (TAS) and elevated Malondialdehyde (MDA) reflect redox imbalance in coronary artery disease (CAD). Their inverse relationship may help assess cardiovascular risk and disease progression.</p><p><strong>Objectives: </strong>To evaluate the association between serum TAS, MDA and the severity of coronary artery damage in CAD patients at Thai Nguyen National Hospital.</p><p><strong>Results: </strong>Serum TAS showed no significant differences by number of stenotic vessels or lesion sites (p > 0.05). TAS was slightly higher in single-vessel disease (1.15 ± 0.38 mmol/L) than in two-vessel (1.08 ± 0.19) and ≥3-vessel groups (1.09 ± 0.18), without statistical significance (p = 0.721). A significant difference was observed only in the right coronary artery (RCA), where TAS peaked in moderate stenosis and decreased in severe stenosis (p = 0.039). In contrast, MDA increased significantly with disease extent: 255.25 ± 48.43 nmol/mL (1-vessel), 281.30 ± 62.56 (2-vessel), and 317.06 ± 54.53 (≥3-vessel) (p = 0.001). MDA also rose markedly with SYNTAX score (low: 239.98 ± 40.96; medium: 271.49 ± 46.53; high: 392.62 ± 90.85 nmol/mL; p < 0.001). ROC analysis showed good diagnostic performance (AUC up to 0.895). TAS did not differ across SYNTAX groups (p = 0.857).</p><p><strong>Conclusions: </strong>TAS is not associated with CAD severity, whereas MDA strongly correlates with disease extent and complexity. MDA may serve as a useful biomarker for oxidative stress and risk stratification in CAD.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1111-1116"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Vitamin D Status with Neurobiological Biomarkers in Healthy Elderly Population.","authors":"E Sanoop, Reshma Kumarchandra, M Madhurya, Anna Cherian","doi":"10.7417/CT.2026.2106","DOIUrl":"10.7417/CT.2026.2106","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD), the most prevalent type of dementia, is a progressive and irreversible neurological disorder that significantly disrupts social and occupational functioning due to cognitive and behavioral decline. It primarily affects older adults globally. Key factors like synaptic plasticity and neurotransmission in dopaminergic neural circuits is being contributed by vitamin D which offers its therapeutical capability and a new diagnostic tool.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted at the Department of Biochemistry, Centre for Basic Sciences, KMC, Mangalore, involving 90 subjects aged between 45-65 with the different vitamin D status grouping them into Deficient (n=30), Insufficient (n=30) and optimum (n=30). Serum biomarkers, including Aβ42, BDNF, Calcium, Glutathione and Acetylcholinesterase, were analyzed using ELISA and spectrophotometric methods from stored samples. Statistical analysis was performed to explore the relationship between vitamin D status and cognitive related biomarkers.</p><p><strong>Results: </strong>This study analyzed neurobiological biomarkers in a study population of 90 individuals with different vitamin D status. Vitamin D status was significantly associated with Aβ42, BDNF, Calcium, Glutathione and Acetylcholinesterase. Individuals in the optimum group exhibited lower Aβ 42 levels and higher levels of BDNF, Calcium and Glutathione compared to deficient and insufficient groups indicating potential neuroprotective and antioxidant benefits.</p><p><strong>Conclusion: </strong>Vitamin D offers a protective role in neurodegeneration in healthy aging adults, the more likely mechanisms being enhanced neurogenesis, improved antioxidant status and modulation of neuronal calcium as hallmarks of reducing the levels of the amyloid marker Aβ42. Amongst these, the effect of vitamin D in increasing BDNF was found to be most significant. Vitamin D does not seem to be involved in cholinergic pathway of neurodegeneration as observed in our study.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1067-1073"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Index Needle Revision for Failed Deep Sclerectomy in Vietnamese Eyes.","authors":"Nguyen Thi Thuy Giang, Bui Thi Van Anh, Pham Trong Van","doi":"10.7417/CT.2026.2099","DOIUrl":"10.7417/CT.2026.2099","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical outcomes of our index needle revision with subconjunctival 5-fluorouracil (5-FU) injection for failed non-penetrating deep sclerectomy (NPDS) in Vietnamese patients.</p><p><strong>Methods: </strong>This prospective study included eyes with failed NPDS that underwent 5-FU-augmented needle revision between 2023 and 2025. Complete and qualified success rates were evaluated at 6 and 12 months postoperatively. Factors potentially associated with procedure success were analyzed.</p><p><strong>Results: </strong>A total of 41 eyes of 33 patients with failed NPDS underwent first needle revision augmented with 5-fluorouracil. The mean patient age was 46.09 ± 16.7 years. Mean pre-needling intraocular pressure (IOP) was 27.66 ± 6.84 mmHg, which was reduced to 14.05 ± 3.22 mmHg, 14.56 ± 5.35 mmHg, and 14.10 ± 3.72 mmHg at 3, 6, and 12 months, respectively (p < 0.001). Best-corrected visual acuity showed a minimal change from 0.67 ± 0.76 preoperatively to 0.65 ± 0.77 at 12 months. Complete and qualified success rates were 78.1% at 6 months, and 68.3% and 70.7%, respectively, at 12 months. Postoperative complications included subconjunctival hemorrhage in 33 eyes (80.5%), hyphema in 4 eyes (9.8%), shallow or flat anterior chamber in 10 eyes (24.4%), corneal epithelial toxicity in 6 eyes (14.6%), iris incarceration in 2 eyes (4.8 %), and hypotony in 4 eyes (9.8%), all occurring in eyes with prior mitomycin C exposure. No cases of endophthalmitis were observed. No significant associations were found between surgical success and patient age, history of previous needle revision, or prior laser goniopuncture, or the interval between the first needle revision and surgery.</p><p><strong>Conclusion: </strong>First-time needle revision augmented with 5-fluorouracil demonstrated satisfactory effectiveness in restoring bleb function in failed NPDS, with an acceptable and predictable safety profile. Most complications were self-limited. Particular caution is recommended when revising thin, avascular blebs, which may be more susceptible to postoperative hypotony.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1017-1022"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocyte Growth Factor in Children of Primary Ciliary Dyskinesia and Its Relation to Disease Severity. A case-control study.","authors":"Eman M Fouda, Maha M K Barakat, Terez B Kamel, Enas S Nabih, Mai M K Barakat, Heba A Ali, Mahitab M Hussein","doi":"10.7417/CT.2026.2120","DOIUrl":"10.7417/CT.2026.2120","url":null,"abstract":"<p><strong>Background: </strong>Primary Ciliary Dyskinesia (PCD) is a rare genetic disorder causing impaired mucociliary clearance, recurrent respiratory infections, and progressive bronchiectasis. Hepatocyte Growth Factor (HGF) plays a role in lung repair and inflammation, but its relationship with clinical and radiological severity in pediatric PCD remains unclear.</p><p><strong>Objective: </strong>To evaluate serum and bronchoalveolar lavage (BAL) hepatocyte growth factor (HGF) levels in children with genetically confirmed primary ciliary dyskinesia (PCD) compared with healthy controls, and to investigate their associations with clinical, functional, and radiological measures of disease severity.</p><p><strong>Methods: </strong>This case-control study was conducted from July 2023 to June 2024 at Ain Shams University Pediatric Tertiary Hospital. Thirty children aged 1-18 years with genetically confirmed (PCD) were included and compared with 30 age- and sex-matched healthy controls. All patient group underwent clinical, functional, and radiological evaluation. Spirometry Pulmonary function was assessed while radiological severity was evaluated by the modified Bhalla score. Nutritional status was assessed by body mass index (BMI) Z-scores, and airway colonization was documented. Serum and bronchoalveolar lavage (BAL) HGF levels were measured in all participants. The relationship between HGF levels and disease severity was evaluated using both univariate and multivariate linear regression analyses. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In multivariable analysis, the modified Bhalla score was identified as an independent predictor of both BAL and serum HGF levels (P = 0.004 and P = 0.010, respectively), while BAL cell count independently predicted BAL HGF (P = 0.048). Serum HGF showed a significant negative correlation with FVC (r = -0.446, P = 0.029) and FEV₁ (r = -0.418, P = 0.042). BAL HGF was negatively correlated with FVC (r = -0.479, P = 0.018).</p><p><strong>Conclusions: </strong>HGF levels in both serum and BAL fluid are significantly associated with disease severity in children with primary ciliary dyskinesia.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1176-1187"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging the invisibility: Predicting histopathology through mammographic clues in invasive breast cancer.","authors":"Pooja Prakash K, M S Athiyamaan, Sourjya Banerjee, Abhishek Krishna, Johan Sunny, Paul Simon, Santosh Rai, Challapalli Srinivas, Dilson Lobo","doi":"10.7417/CT.2026.2104","DOIUrl":"10.7417/CT.2026.2104","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer (BC) is the most common malignancy in women worldwide. Mammographic screening reduces BC mortality across populations, although tumors show intratumoral heterogeneity and diverse imaging patterns. Different clinical and pathological characteristics yield variable mammographic appearances, influencing patient prognosis. Key biomarkers-ER, PR, HER2/neu, and Ki67-are linked to tumor behavior, treatment outcomes, and response to targeted therapies. This study aimed to assess the correlation between mammographic appearance and histopathological features in invasive breast carcinoma.</p><p><strong>Material and methods: </strong>A retrospective review (2019-2023) analysed the records of breast cancer patients. The data included demographics (age, menopausal status), mammographic findings (patterns, morphology, margins, mass, calcifications, focal asymmetric density), and pathological features (histology, grade, ER/PR/HER2, Ki-67, LVSI, PNI, tumor size, nodal status). Statistical analysis was performed via chi-square tests and Student's t tests.</p><p><strong>Results: </strong>Retrospective data from 122 patients were collected. The majority of patients were postmenopausal, with a mean age of 51 years. In the mammograms, 77% had fibroglandular to heterogeneous density with irregular morphological patterns and spiculated margins. Histologically, 82% of patients were proven to have invasive ductal carcinoma. Seventy percent of patients with spiculated masses had increased expression of ER and PR and low ki67%. There was a positive correlation between size on mammogram and tumor grade. Calcification is significant in Her 2-positive patients.</p><p><strong>Conclusion: </strong>Understanding the correlation between mammographic findings and histopathological reports can help in deciding the course of neoadjuvant therapy in the management of breast cancer, which may help improve outcomes.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1049-1057"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Ligamentum Teres Cardiopexy during Laparoscopic Sleeve Gastrectomy on early Intrathoracic Sleeve Migration: A prospective Cohort Study.","authors":"Kirollos Adel Louiz Kamel, Ahmed Mohamed Ibrahim Khalil, Fady Makram Benjamine Rafail, Mohamed Elsayed Farag Eltager","doi":"10.7417/CT.2026.2116","DOIUrl":"10.7417/CT.2026.2116","url":null,"abstract":"<p><strong>Background: </strong>Intrathoracic sleeve migration is a recognized complication after laparoscopic sleeve gastrectomy (LSG) and is frequently associated with postoperative gastroesophageal reflux disease (GERD). Ligamentum teres cardiopexy (LTC) has been proposed as a technique to stabilize the gastroesophageal junction and reduce postoperative sleeve migration.</p><p><strong>Objective: </strong>To evaluate the effect of adding ligamentum teres cardiopexy to laparoscopic sleeve gastrectomy on preventing early intrathoracic sleeve migration and improving reflux-related outcomes.</p><p><strong>Methods: </strong>This prospective cohort study included 40 patients undergoing primary laparoscopic sleeve gastrectomy between April 2024 and April 2025. Twenty patients underwent LSG with ligamentum teres cardiopexy (LSG+LTC), while 20 underwent standard LSG alone. Outcomes assessed at one year included GERD-Health Related Quality of Life (GERD-HRQL) scores, upper gastrointestinal endoscopic Hill's grade, gastric CT volumetry (hernial sac volume and hiatal defect area), operative time, and postoperative complications.</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics were comparable between the two groups. The LSG+LTC group demonstrated significantly lower postoperative symptom severity than the LSG group (16.3 ± 5.9 vs. 22.2 ± 7.8; p = 0.010). Progression of Hill's grade was significantly less frequent in the LSG+LTC group, with postoperative grade III observed in 5% versus 30% of patients (p = 0.038). Patients with LSG+LTC were also more likely to achieve a GERD-HRQL score ≤12 (25% vs. 0%; p = 0.047). Although postoperative hernial sac volume (21.9 ± 10.1 vs. 27.4 ± 11.3 mL; p = 0.109) and hiatal defect area (3.7 ± 0.5 vs. 4.0 ± 0.5 cm²; p = 0.091) were lower in the LSG+LTC group, these differences were not statistically significant. Operative time was significantly longer with LTC (89.7 ± 8.9 vs. 78.9 ± 9.7 minutes; p < 0.001). Postoperative complication rates were comparable between groups.</p><p><strong>Conclusion: </strong>Ligamentum teres cardiopexy performed during laparoscopic sleeve gastrectomy significantly improved postoperative reflux symptoms and endoscopic findings without increasing postoperative complications. Although radiological measures of intrathoracic sleeve migration did not differ significantly, LTC appears to be a safe adjunctive procedure that may improve functional outcomes after sleeve gastrectomy. Larger multicenter studies with longer follow-up are warranted to confirm these findings.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1144-1152"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Direct MRI Arthrography by Combined Distal Radioulnar and Radiocarpal Compartment Contrast Injection Over Conventional MRI in Detection and Differentiation of Triangular Fibrocartilage Complex Injuries.","authors":"Ragab Samir Ibrahem Hemida, Ayman Mohamed Ibrahim, Khaled Ahmed Mohamed, Mohammed Hesham Hassan, Islam Koriem Fattouh, Ahmed Hassan Soliman","doi":"10.7417/CT.2026.2121","DOIUrl":"10.7417/CT.2026.2121","url":null,"abstract":"<p><strong>Background: </strong>Wrist pain is a prevalent and diagnostically complex issue, often stemming from subtle injuries to the triangular fibrocartilage complex (TFCC). Due to the small size and intricate structure of the wrist ligaments, conventional MRI may not reliably detect all TFCC tears, especially peripheral or partial injuries. Direct magnetic resonance arthrography (MRA) has emerged as a superior imaging modality by improving contrast resolution and visualizing joint integrity more precisely.</p><p><strong>Objective: </strong>To evaluate the diagnostic value of direct MR arthrography using combined radiocarpal (RC) and distal radioulnar (DRU) joint contrast injection compared to conventional MRI in detecting and characterizing TFCC injuries.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted on 73 patients (aged 20-43) presenting with chronic wrist pain at Ain Shams University and Misr Radiology Center from January 2023 to December 2024. All patients underwent conventional MRI, followed by direct MRA using combined RC and DRU contrast injection. Arthroscopy was performed as the gold standard.</p><p><strong>Results: </strong>Conventional MRI identified TFCC tears in 30.14% of patients, while direct MRA detected them in 61.64%. When validated against arthroscopy, conventional MRI yielded a sensitivity of 45.65%, specificity of 96.30%, and overall accuracy of 64.4%, with a Kappa value of 0.354 (fair agreement). Conversely, direct MRA demonstrated a markedly higher sensitivity (95.65%), specificity (96.30%), PPV (97.78%), NPV (92.86%), and overall accuracy of 95.9%, with a Kappa value of 0.913 (excellent agreement). Peripheral TFCC tears (Palmer 1b) were the most prevalent subtype (30.14%). Additional pathologies such as scapholunate ligament injuries (48.65%) and ECU tenosynovitis (18.92%) were frequently detected.</p><p><strong>Conclusions: </strong>Direct MRA using combined compartment injection is highly accurate and superior to conventional MRI in diagnosing TFCC injuries. It should be considered an essential imaging tool for evaluating chronic wrist pain and planning surgical intervention.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1188-1200"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of MRI Volumetric Assessment of Hippocampus and its Parts in Early Diagnosis of Mesial Temporal Lobe Epilepsy in Epileptic Children. A case-control study.","authors":"Jailan Hassan Saad Abdallah, Abeer Maghawry Abd-Elhameed, Amina Mohamed Ahmed Farag, Mohamed Yosry Mohamed","doi":"10.7417/CT.2026.2123","DOIUrl":"10.7417/CT.2026.2123","url":null,"abstract":"<p><strong>Background: </strong>Mesial temporal lobe epilepsy (MTLE), commonly associated with mesial temporal sclerosis (MTS), is a major cause of drug-resistant epilepsy in children. Conventional magnetic resonance imaging (MRI) may fail to detect subtle hippocampal abnormalities, particularly in MRI-negative epilepsy. Quantitative MRI volumetric assessment has emerged as a promising method for identifying structural changes not evident on routine imaging.</p><p><strong>Objective: </strong>To evaluate the clinical value of MRI volumetric assessment of the hippocampus and its subfields for the early diagnosis of MTLE in children with epilepsy.</p><p><strong>Methods: </strong>This case-control study was conducted at the MRI Unit, Ain Shams University Hospitals, Cairo, Egypt, between January 2024 and July 2025. A total of 100 children (50 with epilepsy and 50 age- and sex-matched healthy controls) underwent high-resolution brain MRI with three-dimensional T1-weighted imaging. Hippocampal and hippocampal subfield volumes were automatically quantified using VolBrain software. Group comparisons were performed using SPSS version 27, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The epilepsy and control groups were comparable in age and sex. Children with epilepsy had significantly lower total hippocampal volume (4.10 ± 0.66 vs. 4.42 ± 0.87 cm³; p = 0.045) and left hippocampal volume (2.03 ± 0.34 vs. 2.20 ± 0.41 cm³; p = 0.034). The SR-SL-SM subfield demonstrated the greatest volumetric reduction (0.75 ± 0.16 vs. 0.84 ± 0.17 cm³; p = 0.006), while the subiculum was also significantly smaller in the epilepsy group (0.48 ± 0.09 vs. 0.52 ± 0.11 cm³; p = 0.044). Among 38 children with normal conventional MRI findings, quantitative volumetric analysis identified hippocampal abnormalities in 34 cases, corresponding to a detection rate of approximately 89% for MRI-negative epilepsy.</p><p><strong>Conclusion: </strong>MRI volumetric assessment is a valuable adjunct to conventional MRI for detecting subtle hippocampal and hippocampal subfield volume loss in children with epilepsy, including those with normal conventional MRI findings. Quantitative volumetric analysis may improve the detection of structural abnormalities associated with MTLE and supports its use as a complementary imaging tool in the diagnostic evaluation of pediatric epilepsy.</p>","PeriodicalId":50686,"journal":{"name":"Clinica Terapeutica","volume":"177 5","pages":"1208-1215"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}