This is the first completely independent study to confirm that the ISIS is a useful preoperative tool. It is recommended that surgeons consider alternative forms of stabilization if the ISIS is ≥4.

Purpose:To assess the role of diffusion-weighted singleshot echo-planar magnetic resonance imaging (MRI) in patients with mediastinal tumors. Methods:Prospective study was conducted on 45 consecutive patients (29 male, 16 female, age 22-66 years, mean 41 years) with mediastinal tumor. They underwent diffusion-weighted single-shot echo-planar MRI of the mediastinum with a b-factor of 0, 300, and 600 sec/mm 2 . The apparent diffusion coefficient (ADC) value of the mediastinal tumor was correlated with the histopathological findings. Results:The mean ADC value of malignant mediastinal tumors was 1.09 Ϯ 0.25 ϫ 10 Ϫ3 mm 2 /sec, and of benign tumors was 2.38 Ϯ 0.56 ϫ 10 Ϫ3 mm 2 /sec. There was a significant difference in the mean ADC value between malignant and benign tumors (P ϭ 0.001) and within different grades of malignancy (0.001). When an ADC value of 1.56 ϫ 10 Ϫ3 mm 2 /sec was used as a threshold value for differentiating malignant from benign tumor, the best results were obtained with an accuracy of 95%, sensitivity of 96%, specificity of 94%, positive predictive value of 94%, negative predictive value of 96%, and area under the curve of 0.938. Conclusion:The ADC value is a noninvasive parameter that can be used for differentiation of malignant from benign mediastinal tumors and grading of mediastinal malignancy.

No abstract

Background To evaluate the diagnostic performance of chest CT in differentiating coronavirus disease 2019 (COVID-19) and non-COVID-19 causes of ground-glass opacities (GGO). Results A total of 80 patients (49 males and 31 females, 46.48 ± 16.09 years) confirmed with COVID-19 by RT-PCR and who underwent chest CT scan within 2 weeks of symptoms, and 100 patients (55 males and 45 females, 48.94 ± 18.97 years) presented with GGO on chest CT were enrolled in the study. Three radiologists reviewed all CT chest exams after removal of all identifying data from the images. They expressed the result as positive or negative for COVID-19 and recorded the other pulmonary CT features with mention of laterality, lobar affection, and distribution pattern. The clinical data and laboratory findings were recorded. Chest CT offered diagnostic accuracy ranging from 59 to 77.2% in differentiating COVID-19- from non-COVID-19-associated GGO with sensitivity from 76.25 to 90% and specificity from 45 to 67%. The specificity was lower when differentiating COVID-19 from non-COVID-19 viral pneumonias (30.5–61.1%) and higher (53.1–70.3%) after exclusion of viral pneumonia from the non-COVID-19 group. Patients with COVID-19 were more likely to have lesions in lower lobes (p = 0.005), peripheral distribution (p < 0.001), isolated ground-glass opacity (p = 0.043), subpleural bands (p = 0.048), reverse halo sign (p = 0.005), and vascular thickening (p = 0.013) but less likely to have pulmonary nodules (p < 0.001), traction bronchiectasis (p = 0.005), pleural effusion (p < 0.001), and lymphadenopathy (p < 0.001). Conclusions Chest CT offered reasonable sensitivity when differentiating COVID-19- from non-COVID-19-associated GGO with low specificity when differentiating COVID-19 from other viral pneumonias and moderate specificity when differentiating COVID-19 from other causes of GGO.

Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the results of bipolar arthroplasty as an alternative to the standard treatment of internal fixation. Materials and Methods: 41 patients (22 females and 19 males-all were 65 years old or above) who had bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Modified lateral approach was used in all patients. Harris Hip Score (HHS) used for clinical evaluation, however radiological follow up was done using plain X-rays. Follow up period ranged from 12 to 24 months. Results: During the last follow up, the Harris Hip Score ranged from 93 to 51 with a mean value 78.19. Four cases (9.76%) were excellent (91-100), 16 cases (39.02%) good (81-90), 16 cases (39.02%) fair (71-80) and 5 cases (12.02%) poor (≤70). Six cases had complications; infection (1), dislocation (1), stem loosening and subsidence (2), bleeding peptic ulcer (1) and intra-operative crack of the femur while preparing the femoral canal for implant insertion (1). Five patients died within the first year (12.19%). Four patients had revision surgery. Conclusion: Bipolar hemiarthroplasty for the unstable intertrochanteric fractures of the femur in elderly has good early clinical outcome. It is to be considered as one of the treatment options for such injury speciality in case of fragility fractures.