Relationship of Internet addiction with impulsivity and severity of psychopathology among Turkish university students

The previous studies have found a relationship between IA and both impulsivity and psychopathology when they were considered separately. The aim of this study was to investigate the relationship of Internet addiction (IA) with impulsivity and severity of psychopathology among Turkish university students. We also wanted to control the effect of impulsivity dimensions on the relationship between IA and psychopathology. A total of 319 university students from two universities in Ankara participated to the study. Students were assessed through the Internet Addiction Scale (IAS), the Symptom Checklist-Revised (SCL-90-R) and the Barratt Impulsiveness Scale-11 (BIS-11). Correlational analyses revealed that severity of IA was related to both SCL-90-R and BIS-11 scores. Among SCL-90-R subscales, severity of obsessive-compulsive symptoms (OCS) was the only predictor for IAS score. Hierarchical regression analysis indicated that interpersonal sensitivity, additional to attentional and motor impulsiveness, was the predictor of IAS score. Although severity of IA is associated with wide range of psychopathology, particularly OCS, interpersonal sensitivity seems to be the main dimension that predict severity of IAS additional to impulsiveness (attentional and motor). Impulsivity seems to be an important construct when considering IA and its treatment among Turkish university students.     

Alexithymia and personality in relation to social anxiety among university students

The aims of the present study were to investigate the relationship of social anxiety symptoms with alexithymia and personality dimensions in university students and to control the effects of depression and anxiety on this relationship. A total of 319 university students (85 males and 234 females) from two different universities in Ankara were investigated with the Liebowitz Social Anxiety Scale (LSAS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). We found that subscales of the LSAS (fear or anxiety and avoidance) were positively correlated with depression and alexithymia and “difficulty in identifying feelings” (DIF) and “difficulty in describing feelings” (DDF) subscales of the TAS-20. Harm avoidance (HA) showed positive correlations with subscales of the LSAS, whereas self-directedness (SD) showed negative correlations with these subscales. High TAS-20 DDFand HA and low SD predicted fear or anxiety LSAS subscale scores, whereas high TAS-20 DDF, HA and depression scores were predictors for LSAS avoidance subscale scores. Although our sample is not representative of the whole Turkish university student population, we conclude that both fear or anxiety and avoidance were mainly interrelated with DDF and HA, although the causal relationship is not clear.     

Cardiovascular effects of abduction shoulder sling in elderly patients; is it really safe?

Objective

The purpose of the prospective study is to investigate the cardiovascular effects of abduction shoulder sling (ASS) in elderly patients who underwent rotator cuff surgery.

Methods

The study included 49 consecutive patients older than 50 years (mean 59.3 ± 8.2 years) who underwent arthroscopic rotator cuff repair surgery and used ASS in postoperative period. All cases underwent Holter electrocardiographic monitoring before (24 h) and after (48 h) the operation. The Holter findings were read by an experienced cardiologist and a pause of longer than 3 s and heart rate of <40 bpm was evaluated as significant bradycardia.

Results

One patient (61-year-old male) described feeling faint (presyncope) which was confirmed with the Holter finding of a pause more than 3 s which occurred in the day time. Two other patients (52-year-old male, and 62-year-old female) reported severe dizziness (hypotensive attack) which required admission to a general practitioner. However, Holter findings were normal in these patients. These three cases were referred to cardiology department for evaluation of carotid hypersensitivity syndrome (CSH). CSH was confirmed with tests made with provocative maneuvers in a sitting position. CSH was defined as at least 3 s of asystole (cardio-inhibitor type) during carotid massage or systolic blood pressure falling below 50 mmHg (vaso-depressor type). All three patients were obese patients and BMI was higher than 30.

Conclusions

ASS may trigger CSH in short necked and obese patients by exerting mechanical stimulation to the carotid sinus. These patients should be informed about symptoms and signs of CSH and educated on the proper use of ASS and correct positioning of shoulder strap. CSH should be kept in mind in patients who present with dizziness, presyncope and palpitation during the postoperative period.     

Coronal plane fractures of the distal humerus involving the capitellum and trochlea treated with open reduction internal fixation

Introduction

Coronal plane fractures of the distal humerus involving the capitellum and trochlea are rare. Treatments have evolved from closed reduction to open reduction and internal fixation (ORIF) to achieve a stable joint that allows early mobilization.

Background

We determined the functional outcomes of treating coronal plane fractures of the distal humerus with ORIF.

Methods

We reviewed the records of all patients with coronal plane fractures of the distal humerus treated by ORIF. Fractures were classified according to Bryan and Morrey. Cannulated screws were used for fixation. All patients were evaluated using the Mayo Elbow Score Performance Index (MEPI) and disabilities of the arm, shoulder, and hand (DASH) scores at least 1 year later.

Results

Of the 18 patients evaluated (12 women), the mean (SD) age was 45.3(16.5) years (range 16–70). There were seven Type-I, five Type-III, and six Type-IV fractures. Mean follow-up was 43.6 (38.1) months (range 12–120). The mean elbow range of motion in sagittal plane at last follow-up ranged from 8.9° to 132.8°. The mean MEPI score was 86.7 (15.2) points (range 60–100), corresponding to 12 excellent, 2 good, and 4 fair outcomes. The mean DASH score was 15.3 (13.5) points (range 17–35.8). Heterotrophic ossification developed in one patient with delayed fixation; 14 patients with excellent or good results returned to their previous activity levels. Functional scores did not differ by age, sex, or fracture types (P > 0.05 for all comparisons).

Conclusion

ORIF with cannulated screws, which maintain a stable anatomic articular position, provides satisfactory results in coronal plane fractures of the distal humerus.

Level of evidence

Level IV case series.     

Motion correction and registration of high b-value diffusion weighted images

It has been suggested that, high b-value diffusion weighted MRI improves the sensitivity and specificity of these images to tissue microstructure when compared with "clinical" b-value diffusion weighted MRI (b ≈ 1000 s/mm(2)). However, it suffers from poor signal to noise ratio - leading to longer acquisition times and therefore more motion artifacts. Together with the orientational sensitivity of the diffusion weighted MRI signal, the contrast at different b-values and different gradient directions is significantly different. These features of high b-value diffusion images preclude the ability to perform conventional image-registration-based motion/distortion correction. Here, we suggest a framework based on both experimental data (diffusion tensor MRI) and simulations (using the composite hindered and restricted model of diffusion framework) to correct the motion induced misalignments and artifacts of high b-value diffusion weighted MRI. This approach was evaluated using visual assessment of the registered diffusion weighted MRI and the composite hindered and restricted model of diffusion analysis results, as well as residual analysis to assess the quality of the composite hindered and restricted model of diffusion fitting. Both qualitative and quantitative results demonstrate an improvement in fitting the data to the composite hindered and restricted model of diffusion model following the suggested registration framework, thereby, addressing a long-standing problem and making the correction of motion/distortions in data collected at high b-values feasible for the first time.     

Oral intravascular fasciitis: a rare maxillofacial lesion

Nodular fasciitis is a benign non-neoplastic myofibroblastic proliferation, involving the head in 7% to 20% of cases. Intravascular fasciitis (IVF) is a rare variant, with a unique intravascular growth pattern. Only 4 maxillofacial cases have been previously reported. We describe a 58-year-old woman with a rapidly growing, hard, mobile buccal submucosal swelling. CT scans identified a well-defined, 1.7-cm isodense lesion, located between the mental foramen and masseter muscle, which was excised under general anesthesia. A well-defined cellular nodular mass was composed of bland spindle cells, in a densely vascularized, focally myxoid matrix, involving an arterial lumen, and extending into adjacent tissues. Mitoses were rare. Immunohistochemistry was positive for smooth muscle actin, negative for keratins, S-100, epithelial membrane antigen, caldesmon, p53 and Alk. CD31 and CD34 were positive only in the vascular component, supporting the diagnosis of intravascular fasciitis.