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    Differential diagnosis of COVID-19 pneumonia from acute heart failure in pandemic: Importance of radiological and laboratory findings
    (Turkish Assoc Tuberculosis & Thorax, 2021) Kasapogu, Umut Sabri; Gok, Abdullah; Delen, Leman Acun; Sayan, Hasan; Kacmaz, Osman; Cagasar, Ozlem; Karaca, Rukan
    Introduction: COVID-19 pneumonia typically presents with high fever, cough, and shortness of breath and on thorax computed tomography (CT) peripheral ground glass opacities help the diagnosis. Although typical imaging findings for COVID-19 pneumonia are specified in thorax CT, these findings can confused with other diseases. The aim of this study is to investigate the roles of radiological imaging and laboratory findings in the differential diagnosis of COVID-19 pneumonia and acute heart failure (AHF). Materials and Methods: In the present study, 74 patients who admitted to the emergency department with respiratory distress during the pandemic period and received a diagnosis of COVID-19 pneumonia and AHF were included. Laboratory data and radiological findings of the patients, at the time of admission, were evaluated. Results: On admission, there was no difference in age, gender between two groups. However, COVID-19 exposure history was found significantly higher in COVID-19 pneumonia patients group (p< 0.001). Fever, cough, and fatigue were found significantly higher in the COVID-19 pneumonia patients group (p< 0.001). There was difference of lesions distribution between the two groups, centrally distributed lesions were found significantly higher in acute heart failure patients (p< 0.001). Pleural effusion and cardiomegaly were found significantly higher in AHF patients (p< 0.001, p< 0.001). Counts of the white blood cells and lymphocytes were found significantly lower in COVID-19 pneumonia patients 0.003, p= 0.009). COVID-19 pneumonia patients had significantly higher levels of CRP ferritin, LDH and CK compared with AHF patients (p< 0.001, p< 0.001, p= 0.002, p= 0.013). However the level of NT-proBNP was found significantly higher in the AHF patients group (p< 0.001). Conclusion: We believe that laboratory data and thorax CT findings can provide beneficial clinical information in differentiating COVID-19 pneumonia from AHF during the pandemic.
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    Vertebral end-plate changes: Are they clinically significant for postoperative low back pain?
    (Wolters Kluwer Medknow Publications, 2022) Kacar, Emre; Karaca, Rukan; Gunduz, Demet; Korfali, Ender
    Background: Our aim was to assess the relationship between postoperative recurrent low back pain and vertebral body end-plate signal intensity changes on magnetic resonance imaging in disc herniation patients. Materials and Methods: The preoperative magnetic resonance images of 748 patients were retrospectively reviewed. End-plate changes were separated into three groups according to the Modic classification. The postoperative clinical improvement was defined according to the Kawabata criteria. The localization and type of end-plate degeneration and improvement after the operation were analyzed with Pearson's Chi-square test. Results: End-plate degeneration was found in 394 of 748 patients. Single-level and multiple-level end-plate changes were present in 70.4% and 29.6% of the patients, respectively. Type 2 (85.5%), type 1 (10.7%), and type 3 (3.8%) degenerations were encountered in order of frequency. The severities of the end-plate changes were mild, moderate, and severe in 63.2%, 32.7%, and 4.1% of the patients. Type 1 and type 2 degenerations correlated with clinical course in the postoperative period (P < 0.05). Conclusions: Type 1 and type 2 degenerative end-plate changes seen on preoperative magnetic resonance scans can influence the clinical course and be an indicator of postoperative back pain.