University students' attitudes toward mental patients in a developing country

Summary A previous study showed that Turkish and American clinicians and first and fourth year Turkish psychology students were similar to each other in terms of their attitudes toward mental patients. In the present study, first year psychology, science, and medical students were compared to see whether psychology students had more favorable attitudes towards mental patients. In addition, the relationship between the medical students' degree of preference for psychiatry and their attitudes was examined. Analysis of the semantic differential responses revealed that the student groups were basically similar, but psychology and medical students were more similar to each other than to science students. Preference for psychiatry was significantly related to some of the semantic differential items. Possible explanations of the results were discussed and a need for further research was pointed out.     

Prognostic Factors for Isolated Locoregional Recurrences in Colon Cancer and Survival After Salvage Surgery: a Cohort Study

The purpose of this study was to establish the factors affecting development of locoregional recurrence (LR) and survival following salvage surgery in patients operated on for stage I–III colon adenocancer with curative purposes and using a standard technique by an experienced surgeon in elective circumstances. This was a cohort study of patients diagnosed with colon cancer, operated on (n = 312) between January 2003 and 2015. Isolated LR was detected in 15 patients (4.8%) among 312 consecutive patients (99.7% R₀ resection) in a mean follow-up period of 60.5 months. The most important prognostic factors affecting LR development were found to be R₁ resection, pT₄ tumor (tm), postoperative development of morbidity, T₄ tm, N₂ tm, and mucinous tm. All patients who were detected to have isolated LR were re-operated with curative intent (80% R₀). Prognostic factors for cancer-specific survival (CSS) in those cases were development of distant metastasis, localization of the recurrent tumor (pelvis), and symptomatic patient. Mean survival in the whole series was 125.2 months and 5-year CSS was 89%, while respective values in cases with development of LR were 47.4 months and 54.4%, respectively. Although development of isolated LR worsens the prognosis considerably, a long survival and even cure can be provided in some patients. Survival is closely related with resectability and localization of the recurrent tumor and development of distant metastasis. Close follow-up of high-risk patients, early diagnosis and treatment in patients with development of recurrence, experienced team and standardized curative surgery, and a multidisciplinary approach improve the prognosis.     

The efficacy of platelet-rich plasma gel in MRSA-related surgical wound infection treatment: an experimental study in an animal model

Introduction

The wound healing properties of platelet-rich plasma (PRP) gel have been documented in many studies. PRP gel has also become a promising agent for treating surgical site infections. In this study, we investigated the antibacterial activity and wound healing effectiveness of PRP in an animal model of Methicillin-resistant Staphylococcus aureus subsp. aureus (MRSA N315)-contaminated superficial soft tissue wounds.

Materials and methods

Subcutaneous wounds in Wistar Albino male rats were created by making two cm midline incisions followed by inoculation of microorganisms. Study groups comprised of Sham (no treatment), PRP alone, MRSA alone, MRSA?+?PRP, MRSA?+?Vancomycin, and MRSA?+?Vancomycin?+?PRP groups. We inoculated 0.1 mL (3?×?10⁸ CFU/mL) of MRSA in contaminated groups. After 8 days, all rats were killed, wounds were excised and subjected to histopathologic examination, and MRSA counts were determined.

Results

MRSA counts in MRSA, MRSA?+?PRP, MRSA?+?Vancomycin and MRSA?+?Vancomycin?+?PRP groups were 5.1?×?10⁶ (SD?±?0.4) CFU/mL, 4.3?×?10⁶ (SD?±?0.7) CFU/mL, 2.3?×?10⁶ (SD?±?0.3) CFU/mL, 1.1?×?10⁶ (SD?±?0.4) CFU/mL, respectively. The inflammation scores of MRSA?+?PRP, MRSA?+?Vancomycin, and MRSA?+?Vancomycin?+?PRP groups were significantly lower than the MRSA group. MRSA?+?Vancomycin?+?PRP group inflammation score was significantly lower than the MRSA?+?PRP group.

Discussion

All treatment groups were effective in wound healing and decreasing the MRSA counts. MRSA?+?PRP combined created identical inflammation scores to the PRP group. More in vivo studies are required to corroborate these findings.

     

Electrocardiographic Findings at Initial Diagnosis in Children with Isolated Left Ventricular Noncompaction

Background: The aim of this study was to comprehensively evaluate electrocardiographic (ECG) findings of isolated left ventricular noncompaction (IVNC) patients at initial diagnosis and to explore the correlation between them and the clinical, echocardiographic, and magnetic resonance imaging (MRI) findings. Methods: Twenty‐three patients diagnosed with IVNC by echocardiography and cardiac MRI between January 2006 and June 2010 were enrolled in this study. The patients were examined with standard ECG and 24‐hour Holter ECG. For comparison purpose, ECGs of 50 healthy children of similar ages and demographic characteristics were taken. Results: In 87% of patients, ECG abnormalities were found. The most frequently seen ECG findings were left ventricular hypertrophy, ST‐segment depression, and negative T wave related to abnormal repolarization particularly in DII, DIII, and V_4–6 leads, as well as prolonged PR and QTc intervals. No ECG features or patterns were found that were specific to the disease. In contrast to adult patients, while no intraventricular conduction defects (particularly in the left bundle brach) were found in any of our patients, 13% had considerable bradycardia and one required a pacemaker. The Holter ECG recordings showed supraventricular tachycardia attacks in two patients and a short ventricular tachycardia attack in one. Patients whose echocardiograms and MRI showed left ventricular systolic dysfunction and left ventricular dilatation had signs of left ventricular hypertrophy and repolarization abnormality on their ECGs, but there was no significant difference in PR, QRS, and QTc intervals. Conclusion: Regardless of how frequently left ventricular hypertrophy and repolarization abnormalities are found on IVNC patients’ initial ECGs, we think that they are not unique to the disease but are related to the severity of the cardiomyopathy. Ann Noninvasive Electrocardiol 2011;16(2):184–191     

A patient with brucellar cervical spondylodiscitis complicated by epidural abscess

Brucellar cervical spondylodiscitis and epidural abscess are serious medical conditions that can cause permanent neurological deficits. Fortunately, they are rare. We report a 34-year-old male patient, complaining of fever and neck pain and stiffness, with increased deep tendon reflexes. A lumbar puncture was normal. Brucella species organisms were isolated from blood cultures, and the Rose-Bengal test and the standard tube agglutination (STA) test were positive. The diagnosis was made on MRI. The patient was treated with doxycycline and rifampin daily for 16 weeks. On day 51 of treatment, the patient had no symptoms and his physical and neurological examinations were normal. His repeat cervical MRI was almost normal. The STA test was negative at week 20. It is important to consider brucellar cervical spondylodiscitis with epidural abscess in endemic regions.     

Over 14 years of experience with cardiac myxomas

Atrial myxomas are the most commonly encountered tumours of the heart and can present at different ages with different clinical symptoms.They are one of the curable tumours of the heart. Appropriate surgical treatment and surgery must be performed with great precautions in order to prevent fatal systemic embolizations. In this retrospective study we will present our experience of 14 years, between 1990 and 2004, in 27 patients who had been operated for cardiac myxomas. Diagnosis of the myxomas were made by echocardiography in all cases. Surgical approach to the tumour was biatrial in nine, left atrial in II, and transseptal in seven patients. Associated procedures included coronary artery bypass grafting in one, mitral valve repair with tricuspid annuloplasty in two patients, mitral valve replacement in one and bilateral femoral embolectomy in one patient. One hospital mortality occurred as a result of multiorgan failure in a patient with peripheral embolization. None of the patients required recurrent operation, however, mitral valve insufficiency was surgically corrected in one patient.     

Combined analysis of MGMT methylation and dynamic-susceptibility-contrast MRI for the distinction between early and pseudo-progression in glioblastoma patients

IntroductionCurrently, no single diagnostic modality allows the distinction between early progression (EP) and pseudo-progression (Psp) in glioblastoma patients. Herein we aimed to identify the characteristics associated with EP and Psp, and to analyze their diagnostic value alone and in combination.Material and methodsWe reviewed the clinical, conventional magnetic resonance imaging (MRI), and molecular characteristics (MGMT promoter methylation, IDH mutation, and EGFR amplification) of glioblastoma patients who presented an EP (n = 59) or a Psp (n = 24) within six months after temozolomide radiochemotherapy. We analyzed relative cerebral blood volume (rCBV) and relative vessel permeability on K2 maps (rK2) in a subset of 33 patients using dynamic-susceptibility-contrast MRI.ResultsIn univariate analysis, EP was associated with neurological deterioration, higher doses of dexamethasone, appearance of a new enhanced lesion, subependymal enhancement, higher rCBV and rK2 values. Psp occurred earlier after radiotherapy completion and was associated with IDH1 R132H mutation, and MGMT methylation. In multivariate analysis, rCBV, rK2, and MGMT methylation status were independently associated with EP and Psp. All patients with a methylated MGMT promoter and a low rCBV (< 1.75) were classified as Psp while all patients with an unmethylated MGMT promoter and a high rCBV (≥ 1.75) were classified as EP. Among patients with discordant MGMT methylation and rCBV characteristics, higher rK2 values tended to be associated with EP.ConclusionCombined analysis of MGMT methylation, rCBV and vessel permeability on K2 maps seems helpful to distinguish EP from Psp. A prospective study is warranted to confirm these results.