Risky sexual behavior among patients in Turkey with bipolar disorder, schizophrenia, and heroin addiction

AimRisky sexual behavior associated with such sexually transmitted infections (STIs) as hepatitis B and C, herpes, Treponema pallidum, and Neisseria gonorrhoeae, is more frequent among psychiatric patients and parenteral drug abusers than the general population. The aim of this study was to investigate risky sexual behavior in psychiatric outpatients diagnosed with schizophrenia (SCH), bipolar disorder, and heroin addiction (HA), and to compare them with those observed in healthy controls.MethodsThe study group (N = 485; 234 females and 251 males) consisted of patients that consecutively presented to Bak?rkoy State and Training Hospital for Psychiatric and Neurological Diseases in Istanbul and normal healthy controls.Main Outcome MeasuresThe chi‐squared test was used for comparisons between groups and categorical variables. One‐way analysis of variance (post‐hoc Bonferroni test) was used for demographic data. A 22‐item questionnaire for collecting demographic, illness history, and sexual activity data, and a structured 23‐item form for collecting data on risky sexually behavior were administered to the participants.ResultsIn all, 10% of the participants had a positive history for STIs. The majority of risky sexual behaviors was observed among the HA patients. The frequency of being sexually assaulted and having homosexual acts among the SCH group were higher. None of the patients had a positive human immunodeficiency virus (HIV) test result. The frequency of positivity for hepatitis B and C markers was highest among the HA patients.ConclusionsThe provision of information and training about all STIs and risky sexual behavior should become routine in the treatment of mentally ill patients, especially those that abuse drugs. Hariri AG, Karadag F, Gokalp P, and Essizoglu A. Risky sexual behavior among patients in Turkey with bipolar disorder, schizophrenia, and heroin addiction. J Sex Med 2011;8:2284–2291.     

Combined diffusion-weighted MRI and MR spectroscopy: Feasibility to improve the MRI capability in differentiation between benign and malignant neck lymphadenopathy

The study aims to evaluate the additional value of MRS and DWI in differentiating malignant and benign neck lymphadenopathy.Materials and methods: Thirty-three patients with enlarged neck lymph nodes of malignant suspicious underwent DWI and MRS. ADC values, presence of Cho peak and Cho/Creatine ratio of the dominant node were assessed and results were compared with histopathological results.Results: the patients were classified into benign (n = 9) and malignant (n = 24: 17 metastases and 7 lymphoma). The mean ADC values of the benign, metastasis and lymphoma patients were 1.56 ± 0.23, 1.01 ± 0.23 and 0.71 ± 0.02 × 10^?3 mm²/s respectively. It was significantly higher in benign than malignant (p < 0.0001) and in metastatic than lymphomatous (p = 0.001) as well as in well- and moderately than poorly differentiated metastatic (p = 0.01) lymph nodes. Using the receiver operating characteristic (ROC), cutoff value of 1.15 × 10^?3 mm²/s of ADC could differentiate benign from malignant nodes with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of 91.6%, 77.7%, 91.9%, 77.7%, KAPPA = 0.69 and p < 0.001 respectively.Malignant nodes showed a significant choline peak (n = 24, 100%) while benign nodes showed choline peak in only two cases (22%). Mean Cho/Cr ratio was significantly higher in malignant nodes than benign ones (2.64 ± 1.16 versus 1.09 ± 0.04) (p < 0.0001), furthermore it was significantly higher in lymphoma versus metastatic (4.3 ± 0.35 versus 1.94 ± 0.34, p < 0.001) as well as poor versus Well- to moderately differentiated metastases (2.3 ± 0.11 versus 1.69 ± 0.18, p < 0.01). The MRS sensitivity, specificity, PPV, NPV and Kappa in differentiating benign and malignant cervical lymph nodes were 100.0, 77.7, 92.3, 100.0% and 0.83 and p value = 0.001.Combination of DWI and MRS showed higher diagnostic value than DWI or MRS alone with sensitivity, specificity, PPV, NPV and Kappa of 100, 88.9, 96, 100% and 0.92 respectively (p < 0.0001).Conclusion: ADC and MRS can help in the differentiation between malignant and benign neck lymph nodes. Combination of both techniques achieved higher diagnostic performance.     

Peritonitis rates and common microorganisms in continuous ambulatory peritoneal dialysis and automated peritoneal dialysis

Background:  The aim of the present study was to perform a multicenter investigation in Turkish children on chronic peritoneal dialysis by examining the rates of peritonitis as well as causative organisms according to year.
Methods:  Twelve pediatric renal units participated in this study and data were obtained by review of the medical records.
Results:  One hundred and thirty-two patients were on continuous ambulatory peritoneal dialysis (CAPD), 21 were on automated peritoneal dialysis (APD) and 59 were on CAPD and APD at different times. Mean durations of CAPD and APD were 24.2 ± 21.1 months and 22.9 ± 12.8 months, respectively. Seventy-one (33%) out of 212 patients had no peritonitis episode. Overall peritonitis rate was one episode per 15.5 patient-months. The peritonitis rate was one episode per 15.4 patient-months for APD and one episode per 15.6 patient-months for CAPD. Coagulase-negative staphylococcus was the most common cause of peritonitis among patients with positive culture (20.6%). While the incidence of Gram-negative infection remained unchanged according to year in patients on CAPD ( P  = 0.68), the rate of Gram-negative peritonitis in children on APD was significantly higher ( P  = 0.03).
Conclusions:  Peritonitis rate was similar in CAPD and APD, but the risk of Gram-negative peritonitis in APD was higher than that of CAPD.     

High resolution spiral CT scan in the diagnosis of pseudoaneurysm of ascending aorta

Pseudoaneurysms of the ascending aorta are rare (<1%), and extremely rare from aortic vent site, but can be a lifethreatening complication. The basic methods of diagnosis are computed tomography scan and aortography. We report high resolution spiral CT may provide the best less invasive means in the diagnosis of the pseudoaneurysm of the ascending aorta originated from the aortic vent site.     

The safety and efficacy of systemic versus catheter-based therapies: application of a prognostic model by a pulmonary embolism response team

Journal of Thrombosis and Thrombolysis - The decision by pulmonary embolism response teams (PERTs) to utilize anticoagulation (AC) with or without systemic thrombolysis (ST) or catheter-directed...     

Functional disability in children with hemophilic arthropathy

Hemophilia is a coagulation disorder characterized by acute hemorrhages into the musculoskeletal system, leading eventually to arthropathy and disability. We investigated the functional loss, namely disability, in hemophiliacs. The clinical and radiological characteristics of joint involvement were also evaluated. There were 31 patients between the ages of 3 and 18 years and 65 involved joints. The knees were the most commonly affected joints followed by the elbows and ankles. There was a positive correlation between the radiological and clinical evaluation scores; however, the clinical evaluation score did not correlate with age. The radiological score increased in conjunction with increasing age of the patients. We observed a significant relationship between the disability score and the clinical evaluation and radiological scores. These observations suggest that hemophilia is a life-long condition, with a high potential for functional disability if not promptly and adequately controlled. The main principle in the treatment of hemophilic arthropathy is the restoration of the patient’s lifestyle and mobility with a comprehensive multidisciplinary approach.