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Background/aim: The main purpose of this study is to evaluate the resting state hippocampal connectivity with language areas and to correlate them with laterality index calculations on single subject basis, hence to present hippocampal lateralization for language with rs-fMRI. Materials and methods: Task based and rs-fMRI data were gathered from a total of 45 subjects in 3T scanner. BrainVoyager QX, SPM, and CONN softwares were used for data analysis. LI score of each subject was calculated and converted into normalized LI score (nLI). Intrahemispheric rs-connectivity analysis was performed between hippocampus and Broca's regions on both sides. Correlation between these variables was measured with SPSS software. Results: Right-TLE patients were found to have highest whereas left-TLE group were found to have lowest mean LI scores. Regarding hippocampal-lingual networks; left intrahemispheric connectivity values showed strong positive correlation with nLI values in left, right-TLE patients and healthy controls (P = 0.035, 0.014, 0.047). There were no significant correlation between right intrahemispheric connectivity values and nLI scores in all groups. Conclusions: This study seems to depict the existence of resting state hippocampal-lingual functional network which correlates well with lateralization of language function in the left hemisphere in both temporal lobe epilepsy patients and healthy controls.
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Dominancia Cerebral/fisiología , Epilepsia del Lóbulo Temporal/fisiopatología , Hipocampo/fisiopatología , Adolescente , Adulto , Epilepsia del Lóbulo Temporal/diagnóstico por imagen , Femenino , Hipocampo/diagnóstico por imagen , Humanos , Lenguaje , Imagen por Resonancia Magnética , Masculino , Percepción/fisiología , Descanso/fisiología , Adulto JovenRESUMEN
OBJECTIVES: The aim of this study was to compare the diagnostic performance of different sonographic modalities for diagnosing lateral epicondylosis. METHODS: A total of 50 symptomatic and 50 asymptomatic common extensor tendons in 44 patients with lateral epicondylosis, and 25 healthy participants were prospectively examined by B-mode sonography, color Doppler imaging, power Doppler imaging, Superb Microvascular Imaging (SMI; Toshiba Medical Systems Corporation, Tokyo, Japan), and strain elastography. We evaluated blood flow in common extensor tendons by using a grading system with color Doppler imaging, power Doppler imaging, and SMI. The diagnostic performance of the modalities was compared. RESULTS: When a cutoff value of hypoechogenicity was used for the mean strain ratio, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates were 92.0%, 94%.0, 93.9%, 92.2%, and 93.0%, respectively. When a cutoff point of grade 1 was used, the sensitivity, specificity, PPV, NPV, and accuracy rates were 26.0%, 10.0%, 10.0%, 57.5%, and 63.0, for color Doppler imaging; 40.0%, 10.0%, 10.0%, 62.5%, and 70.0% for power Doppler imaging; and 84.0%, 94.0%, 93.0%, 85.5%, and 89.0% for SMI. When a cutoff value of 3.94 was used for the mean strain ratio, the sensitivity, specificity, PPV, NPV, and accuracy rates were 78.0%, 92.0%, 90.7%, 80.7%, and 85.0%, respectively. A statistically significant correlation was detected between SMI, strain elastography, and visual analog scale scores (P < .001). CONCLUSIONS: The combination of SMI and B-mode sonography was found to have excellent diagnostic performance for lateral epicondylosis. Neovascularzation in patients' tendons with lateral epicondylosis was identified much better with SMI compared to color or power Doppler imaging.
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Procesamiento de Imagen Asistido por Computador/métodos , Microvasos/diagnóstico por imagen , Codo de Tenista/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anciano , Diagnóstico Diferencial , Articulación del Codo/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Codo de Tenista/fisiopatología , Adulto JovenRESUMEN
OBJECTIVES: This retrospective study aims at demonstrating the success rate, effectiveness, and advantages of alcohol as a scolicidal and sclerosing agent for the percutaneous treatment of liver hydatid cysts. METHODS: A total of 554 liver hydatid cysts obtained from 347 patients admitted between January 2008 and February 2016 were retrospectively investigated. Of these, 435 (78.5%), 91 (16.4%), and 28 (5%) were classified as Gharbi type 1, 2, and 3, respectively. Type 1 and 2 cysts were treated using PAIR (puncture, aspiration, injection, respiration) and single puncture catheterization methods; type 3 lesions were treated using a modified catheterization technique. Alcohol was used as a scolicidal and sclerosing agent in all procedures. RESULTS: After excluding three lesions (0.5%) because of lack of parenchymal support during catheterization, 274 (49.7%), 250 (45.3%), and 27 (4.9%) of 551 lesions were treated with PAIR, single puncture catheterization, and modified catheterization techniques, respectively. Therefore, a 99.5% of technical success rate was obtained. Major complications in 2 patients (0.5%) and minor complications were observed in 36 patients (10.3%). Mean hospital stay was 1.55±2.3 days (range: 0-23 days). Patients were followed-up for mean 19.6 months (range: 6-83 months), during which recurrences were detected in 19 patients (5.4%). CONCLUSIONS: The use of alcohol as a scolicidal and sclerosing agent during the percutaneous treatment of liver hydatid cysts is associated with a high success rate and low rates of recurrence and complications, and should be considered an important alternative to surgical procedures.
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Cateterismo , Equinococosis Hepática/diagnóstico , Equinococosis Hepática/terapia , Etanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Ultrasonografía Intervencional , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cateterismo/métodos , Niño , Preescolar , Equinococosis Hepática/clasificación , Equinococosis Hepática/parasitología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Succión , Resultado del Tratamiento , Ultrasonografía Intervencional/métodosRESUMEN
AIM: To investigate the relationship between body dysmorphic syndrome and self-esteem in rhinoplasty candidates. RESULTS: A negative statistical correlation was evident between Rosenberg Self-Esteem Scale (RSES) and Body Dysmorphic Disorder Examination-Self Report (BDDE-SR) scores. In terms of responses to the first Body Dysmorphic Disorder Questionnaire (BDDQ) question, which focuses on general attitude toward body dysmorphic syndrome, the average RSES "YES" score was significantly less than the "NO" score. No significant differences appeared between RSES scores and scores for the 4th subgroup of BDDQ questions (subgroups A, B, and C; these questions explore how much time is spent daily on maintenance of bodily appearance). However, significant differences appeared between scores for the 4th subgroup of BDDQ questions and BDDE-SR scores. The average BDD-SR score of subgroup A (less than 1âhour spent on bodily maintenance) was significantly lower than those of group B (1-3âhours) and group C (more than 3âhours). However, no significant differences appeared in average BDD-SR scores between subgroups B and C. MATERIALS AND METHODS: In this prospective study, 56 patients (31 females and 25 males) were evaluated preoperatively using the BDDQ, the BDDE-SR, and the RSES. Patients younger than 15 years and those with deformities caused by trauma were excluded. CONCLUSIONS: Rhinoplasty candidates had higher levels of body dysmorphic disorder (BDD). Although patients with low RSES scores were more likely to have BDD, rhinoplasty candidates were not notably deficient in self-esteem. However, in rhinoplasty candidates with low RSES scores, the frequency of BDD was elevated. Therefore, the authors suggest that rhinoplasty candidates with low RSES scores should be investigated carefully in terms of BDD.
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Trastorno Dismórfico Corporal/diagnóstico , Trastorno Dismórfico Corporal/psicología , Rinoplastia/psicología , Autoimagen , Adulto , Femenino , Humanos , Masculino , Estudios Prospectivos , Estadística como Asunto , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: The primary objective was to conduct a comparative analysis of homicide cases and their perpetrators with psychotic illnesses in samples from Turkiye and Russia to elucidate contextual similarities and differences, and providing novel perspectives to enhance international research in this field. METHOD: This cross-national retrospective study, conducted at forensic psychiatric centers in Istanbul, Turkiye, and Chuvashia, Russia, involved individuals with psychotic illnesses (ICD-10 F20-F29) who were deemed criminally non-responsible for index homicide offenses between December 2012 and December 2022. The sample included 92 Turkish patients and 29 Russian patients who were compared for background, clinical characteristics, and each homicidal act. RESULTS: Binary analyses revealed that Russian subjects were more educated, had more lifetime suicide attempts, longer illness duration, had acquaintances as victims more frequently, higher rates of blunt traumatic homicides, higher rates of intoxication with alcohol or substances, and lower rates of experiencing delusions at the time of the index homicide compared to their Turkish counterparts. Multivariate analyses indicated that more years of education, a greater frequency of lifetime suicide attempts, higher prevalence of intoxication and a lower rate of delusions at the time of the homicide were associated with belonging to the Russian group. CONCLUSION: Despite several similarities, the remarkable differences between the two samples underscore the importance of international research in enhancing our understanding of mental health, homicidal offense and offender characteristics in the sociocultural context.
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Homicidio , Salud Mental , Humanos , Homicidio/psicología , Estudios Retrospectivos , Turquía/epidemiología , Federación de Rusia/epidemiologíaRESUMEN
PURPOSE: The present study aims to (1) assess the technical success and limb salvage rates of endovascular therapy in patients with critical limb-threatening ischemia (CLTI) and infra-popliteal Trans-Atlantic Inter-Society Consensus (TASC) C/D lesions according to the updated 2015 TASC II classification and (2) to present our institutional experience. METHODS: A single-center retrospective study was conducted on patients with TASC C/D CLTI who underwent endovascular treatment between 2012 and 2017. The follow-up protocol consisted of Doppler ultrasound conduction every 3 months for the first year unless patients showed symptoms of CLTI. Patients with at least 1 year of follow-up data were included in the study, and if applicable their 3-year results were evaluated in terms of primary patency, absence of amputation, amputation-free survival, and overall survival. RESULTS: A total of 248 patients and 287 limbs (238 TASC D lesions and 49 TASC C lesions) were treated via infra-popliteal percutaneous transluminal angioplasty. The overall technical success was 87%, the primary patency rate was 41.5% in the first year, and the freedom from amputation rates were 80.8% in 1 year and 67.7% in 3 years. CONCLUSION: In patients with infra-popliteal arterial occlusive diseases, endovascular treatment methods demonstrate a high rate of technical success and favorable outcomes in limb preservation.
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Background: Synthetic cannabinoids (SCs) users appeared to have heightened risk for cardiac arrhythmias; however, current line of research is insufficient in terms of demonstrating both conventional and novel electrocardiographic arrhythmia risk indicators in this population. Objective(s): We aimed to investigate P-wave dispersion (Pwd), corrected QT interval (QTc), QTc dispersion (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT ratio, corrected JT interval (JTc), and JTc dispersion (JTcd), which are shown among the risk factors for emergence of an arrhythmia, among SCs users, suggestive of possible adverse effects of SCs on the cardiac rhythm. Methods: Forty-one male SCs user patients who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use disorder criteria and 41 healthy male controls included in the study. Substance-related characteristics were recorded. Electrocardiography recordings under standardized procedure of all participants were performed and arrhythmia risk markers were calculated from electrocardiograms (ECGs). Results: Age and heart rate per minute did not significantly differ between the groups. SCs user group had significantly higher Pwd, QTc, QTcd, Tp-e, Tp-e/QTc ratio, JTc, and JTcd values compared with controls. Among risk markers, only Pwd was significantly correlated with duration of SCs use. Conclusions: Alterations in ECG-derived markers of arrhythmia, which are acquired through an easy and cheap method, should be evaluated for the prediction and prevention of severe cardiac conditions in patients with SCs use.
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Cannabinoides , Cardiopatías , Humanos , Masculino , Arritmias Cardíacas/inducido químicamente , Arritmias Cardíacas/diagnóstico , Electrocardiografía/efectos adversos , Electrocardiografía/métodos , Cardiopatías/inducido químicamente , Cardiopatías/complicaciones , Factores de Riesgo , Cannabinoides/efectos adversosRESUMEN
In this retrospective 3-year mirror-image study, 81 patients with schizophrenia spectrum disorders (SSD) were categorized according to whether they were prescribed long-acting injectable antipsychotics (LAI) or not upon discharge from the inpatient forensic psychiatric unit. Antipsychotic adherence, which was staged based on the 'proportion of days covered' method, as well as other clinical outcomes was compared between pre- and post-index mirror periods. In both Oral-only (nâ =â 46) and Oral + LAI (nâ =â 35) groups, the number of hospitalizations, convictions and months spent in the hospital were significantly lower in the post-index period than the pre-index period. Differences in these three variables between pre- and post-index periods were NS between the two groups. A mixed effect ordinal logistic regression model with random intercept showed that the odds ratio of obtaining a higher treatment adherence score in the post-index period was more pronounced in the Oral + LAI group than in the Oral-only group, considering adherence at baseline and the length of stay during the index hospitalization as potential confounders. Discharge with LAIs in a forensic psychiatric cohort of SSD was associated with a greater mid- to long-term improvement in antipsychotic medication adherence compared to discharge with oral-only antipsychotics.
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AIM: To present the clipping of a ruptured aneurysm in the M1 segment of the right middle cerebral artery after rebleeding, which was treated with Woven EndoBridge (WEB). CASE REPORT: A 68-year-old male patient with known hypertension, coronary artery disease and benign prostatic hypertrophy was admitted to our clinic after a ruptured aneurysm of 4.5 mm in the right middle cerebral artery M1 segment and subarachnoid hemorrhage were detected in the emergency room imaging after syncope at home. WEB device was placed into the aneurysm in the patient who was planned for endovascular treatment. After 3 days of the procedure, neurologic examination showed regression. In the brain computed tomography imaging, it was observed that there was an intraparenchymal hematoma of 4,5 cm in the right temporoparietal region and the aneurysm, which had been treated with endovascular WEB, was ruptured. The aneurysm was clipped in the patient for whom emergency surgical treatment was planned. CONCLUSION: As a conclusion, re-bleeding can be seen after aneurysm treatment with the Web device. If it is planned to re-close the aneurysm treated with the web device with a surgical clip, the pressure created by the device against the vessel can be reduced with the additional clip.
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Aneurisma Roto , Masculino , Humanos , Anciano , Aneurisma Roto/complicaciones , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/cirugía , Hematoma , Hospitalización , Arteria Cerebral Media , NeuroimagenRESUMEN
The main aim of this study was to ascertain whether a relationship existed between the modus operandi and motivation of homicide, clinical characteristics, and psychopathic traits in schizophrenia. Forty-seven male homicide perpetrators with schizophrenia were included in the study. We classified types of homicide perpetrated by the patients as predominantly impulsive (n = 27) or proactive (n = 20) in nature. We also evaluated the psychotic motivation accompanying the homicide. Forty-four (93.6%) of the homicides were psychotically motivated. The victim was a stranger in only 8.5 percent of the homicides. Use of firearms as a killing method was significantly higher in predominantly proactive homicides (30%) compared with impulsive homicides (3.7%). Infidelity delusions were more frequent in proactive homicides than in impulsive homicides. According to regression models, a predominantly proactive homicide was significantly associated with being married, older age at illness onset, killing with firearms, infidelity delusions and a high PCL-R affective facet score in univariate analyses. Multivariate analyses showed a significant association with infidelity delusions and a high PCL-R affective facet score. Our results confirm that certain predispositions, as well as contextual factors, may be associated with the violent subtype of homicidal behavior in perpetrators with schizophrenia.
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Homicidio , Esquizofrenia , Humanos , Masculino , Homicidio/psicología , Agresión/psicología , Motivación , MatrimonioRESUMEN
ABSTRACT: In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.
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Páncreas , Neoplasias Pancreáticas , Humanos , Estudios Retrospectivos , Páncreas/diagnóstico por imagen , Páncreas/patología , Biopsia con Aguja Fina/efectos adversos , Biopsia con Aguja Fina/métodos , Biopsia con Aguja Gruesa/efectos adversos , Biopsia con Aguja Gruesa/métodos , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Ultrasonografía Intervencional/métodosRESUMEN
The present study attempted to assess the dissociative symptoms and overall dissociative disorder comorbidity in patients with obsessive-compulsive disorder (OCD). In addition, we examined the relationship between the severity of obsessive-compulsive symptoms and dissociative symptoms. All patients admitted for the first time to the psychiatric outpatient unit were included in the study. Seventy-eight patients had been diagnosed as having OCD during the 2-year study period. Patients had to meet the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD. Most (76.9%; n = 60) of the patients were female, and 23.1% (n = 18) of the patients were male. Dissociation Questionnaire was used to measure dissociative symptoms. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Dissociative Disorders interviews and Yale-Brown Obsessive Compulsive Checklist and Severity Scale were used. Eleven (14%) of the patients with OCD had comorbid dissociative disorder. The most prevalent disorder in our study was dissociative depersonalization disorder. Dissociative amnesia and dissociative identity disorder were common as well. The mean Yale-Brown score was 23.37 ± 7.27 points. Dissociation Questionnaire scores were between 0.40 and 3.87 points, and the mean was 2.23 ± 0.76 points. There was a statistically significant positive correlation between Yale-Brown points and Dissociation Questionnaire points. We conclude that dissociative symptoms among patients with OCD should alert clinicians for the presence of a chronic and complex dissociative disorder. Clinicians may overlook an underlying dissociative process in patients who have severe symptoms of OCD. However, a lack of adequate response to cognitive-behavioral and drug therapy may be a consequence of dissociative process.
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Trastornos Disociativos/epidemiología , Trastorno Obsesivo Compulsivo/epidemiología , Adolescente , Adulto , Comorbilidad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Disociativos/diagnóstico , Femenino , Humanos , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/diagnóstico , Encuestas y CuestionariosRESUMEN
AIM: To investigate the effects of video-based information on the anxiety of patients who underwent ultrasound-guided thyroid fine-needle aspiration biopsy. METHODS: Fifty consecutive patients who underwent thyroid fine needle aspiration biopsy were included in the study prospectively. Patients were divided into two groups before the biopsy. 25 patients in Group 1 received only written information about thyroid biopsy. In Group 2, 25 patients received video-based information along with written information. Baseline anxiety of all the patients was evaluated prior to procedure using STAI-S and STAI-T questionnaires. After the written information was provided to the patients in group 1, the STAI-S questionnaire was repeated. In the same way, group 2 patients were asked to repeat the STAI-S questionnaire after written and video-based information were provided. All patients were asked to evaluate pain during biopsy using visual analog scale (VAS). RESULTS: There was no significant difference between the groups in terms of age and gender. Although the VAS score was lower in group 2, there was no statistically significant difference between the two groups. When the groups were compared in terms of basal anxiety scores, STAI-T was similar in both groups (p = 0.708). Although STAI-S values were similar in pre and post-information patients in Group 1, the STAI-S values in group 2 were statistically significantly decreased. CONCLUSION: The video based information provided prior to thyroid biopsy draws the attention as an effective and easy to apply method to decrease the anxiety of the patients.
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Ansiedad , Glándula Tiroides , Ansiedad/diagnóstico , Ansiedad/epidemiología , Ansiedad/etiología , Biopsia , Humanos , Dolor , Dimensión del Dolor , Glándula Tiroides/diagnóstico por imagenRESUMEN
OBJECTIVE: The aim of study is to evaluate the results of deployment of Percutaneous Radiological Gastrostomy (PRG), which is a good alternative to Surgical Gastrostomy (SG), with transoral approach in cases where Percutaneous Endoscopic Gastrostomy (PEG) is contraindicated, difficult or unsuccessful, in patients with high risk of American Society of Anesthesiologists with four scores. In addition, we aimed to demonstrate the advantages of mushroom pull type catheters over push type gastrostomy catheters. METHODS: This retrospective study included a total of 40 patients (18 females and 22 males) aged 21-92 years who underwent PRG with the antegrade transoral approach. PRG was performed by retrograde passing through the esophagus or snaring the guidewire from the stomach and taking out of the anterior abdominal wall. Patients' demographic data, indications for PRG, procedural outcomes and complications were screened and recorded. RESULTS: PRG was performed in 39 of 40 patients included in the study. Technical success rate was 97.5%. Procedure-dependent major complications such as death, aspiration, colon perforation, and deep abscess were not observed. Aspiration occurred in the first patient during the first feeding on the day after the procedure. Major complication rate was 2.5%. The total minor complication rate was 17.5% in 7 patients; parastomal leakage in 2 patients (5%), skin rash and infection in 3 (7.5%) patients, minor bleeding in 2 (5%) patients with oropharynx cancer, minimal bleeding from the gastrostomy catheter 1 week after the procedure in 1 (2.5%) patient. None of the cases had buried buffer. Tube functionality was preserved in all patients without any damage. CONCLUSION: Mushroom tip (pull type) gastrostomy catheter is a safe treatment method for patients requiring prolonged feeding because of wide diameter, endurance, long staying opening duration, less excessive dilatation and parastomal leakage, and no need for gastropexy. Lower cost and easier access are advantageous for mushroom tip pull type catheters compared to push type gastrostomy catheters in our country. The less invasive PRG is an alternative option in patients who are difficult to administer PEG, are at high anesthesia risk and cannot be sedated. ADVANCES IN KNOWLEDGE: This article is valuable in terms of its contribution to develop an alternative radiological method for the deployment of gastrostomy tubes in medical difficult patients. This method has shortened the duration of the procedure and increased the success rate in patients with difficulty in transition from the stomach to the esophagus or with difficulty in the upper gastrointestinal tract. Mushroom tip catheters can be placed successfully by radiological methods.
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Anestesia/efectos adversos , Gastrostomía/instrumentación , Gastrostomía/métodos , Neoplasias Laríngeas/complicaciones , Neoplasias Orofaríngeas/complicaciones , Radiografía Intervencional/métodos , Adulto , Anciano , Anciano de 80 o más Años , Catéteres , Femenino , Fluoroscopía , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Riesgo , Estómago/diagnóstico por imagen , Estómago/cirugía , Adulto JovenRESUMEN
There is considerable evidence on the role of personality traits in the risk of criminal recidivism among schizophrenia patients, besides conventional risk factors. We evaluated the effects of psychopathy and biopsychosocial personality model on general criminal recidivism in schizophrenia patients. Ninety-four male DSM-5 diagnosed schizophrenia patients were recruited and classified into three groups according to the number of offenses since diagnosis: reoffenders (n = 32), Initial offenders (n = 31), and nonoffenders (n = 31). All subjects were evaluated by the Turkish versions of Psychopathy Checklist-Revised (PCL-R) and Temperament and Character Inventory-Revised (TCI-R). In Reoffenders, all subscale scores of PCL-R and Novelty seeking were the highest, while Self-directedness and Cooperativeness were the lowest. PCL-R Total, Factor 1 and Factor 2 positively correlated with Novelty Seeking, and negatively correlated with Harm Avoidance, Self-directedness, and Cooperativeness in offender patients. For criminal recidivism in offender patients, high PCL-R Total and Novelty Seeking, low Harm Avoidance, Self-directedness, and Cooperativeness, being unmarried, presence of childhood adversity, and younger age at the first offense were found to be significant predictors in univariate analyses; multivariate regression models revealed PCL-R Total and Persistence as the only significant predictors. These results suggest that certain dimensional personality evaluations combined with potential historical, clinical, and forensic risk factors can be employed in forensic settings to screen offender schizophrenia patients at an increased risk of recidivism and to take necessary precautions against further criminal behavior.
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Criminales/psicología , Reincidencia , Esquizofrenia , Adulto , Trastorno de Personalidad Antisocial/psicología , Conducta Criminal , Estudios Transversales , Psiquiatría Forense , Humanos , Masculino , Determinación de la Personalidad , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Psicología del Esquizofrénico , TemperamentoRESUMEN
PURPOSE: A zero coronary calcium score (CCS) is not able to provide a definite exclusion for coronary artery disease (CAD). The goal of this study was to determine the prevalence and associated cardiovascular risk factors of CAD in patients with zero CCS. METHODS: Six hundred thirteen patients with zero CCS referred to coronary calcium score analysis (CCSA) and coronary computed tomography angiography (CCTA) with suspicion of CAD were included. The descriptive, univariate, and multivariate analyses were used to determine the prevalence and predictors of CAD presence. RESULTS: Among 613 patients, 17 patients (2.7%) have NCCP, and obstructive CAD was found in 3 patients (0.48%). Multivariate analysis revealed that male gender and older age (≥50 years) were significantly associated with the presence of noncalcified coronary plaques (NCCP) (p < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the male gender and older age (≥50 years) model had 70.6% sensitivity and 84.2% specificity for predicting NCCP. CONCLUSION: A non-negligible portion of patients with zero CCS had CAD. Male gender and older age (≥50 years) were independently associated with NCCP. Due to the high specificity value (84.2%) and negative predictive value (99.0%) of the male gender and older age (≥50 years) model, selective use of CCTA is recommended in <50 years old female patients to avoid unnecessary radiation exposure.
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Calcio , Enfermedad de la Arteria Coronaria , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND: The pathobiology of schizophrenia is still unclear. Its current treatment mainly depends on antipsychotic drugs. A leading adverse effect of these medications is the acquired long QT syndrome, which results from the blockade of cardiac HERG1 channels (human ether-a-go-go-related gene potassium channels 1) by antipsychotic agents. The HERG1 channel is encoded by HERG1 (KCNH2, Kv11.1) gene and is most highly expressed in heart and brain. Genetic variations in HERG1 predispose to acquired long QT syndrome. We hypothesized that the blockade of HERG1 channels by antipsychotics might also be significant for their therapeutic mode of action, indicating a novel mechanism in the pathogenesis of schizophrenia. METHODS: We genotyped four single nucleotide polymorphisms (SNPs) in 7q36.1 region (two SNPs, rs1805123 and rs3800779, located on HERG1, and two SNPs, rs885684 and rs956642, at the 3'-downstream intergenic region) and then performed single SNP and haplotype association analyses in 84 patients with schizophrenia and 74 healthy controls after the exclusion of individuals having prolonged or shortened QT interval on electrocardiogram. RESULTS: Our analyses revealed that both genotype and allele frequencies of rs3800779 (c.307+585G>T) were significantly different between populations (P = 0.023 and P = 0.018, respectively). We also identified that two previously undescribed four-marker haplotypes which are nearly allelic opposite of each other and located in chr7:150225599-150302147bp position encompassing HERG1 were either overrepresented (A-A-A-T, the at-risk haplotype, P = 0.0007) or underrepresented (C-A-C-G, the protective haplotype, P = 0.005) in patients compared to controls. CONCLUSIONS: Our results indicate that the potassium channel gene HERG1 is related to schizophrenia. Our findings may also implicate the whole family of HERG channels (HERG1, HERG2 and HERG3) in the pathogenesis of psychosis and its treatment.
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Canales de Potasio Éter-A-Go-Go/genética , Desequilibrio de Ligamiento , Síndrome de QT Prolongado/genética , Polimorfismo de Nucleótido Simple , Esquizofrenia/genética , Adulto , Antipsicóticos/uso terapéutico , Estudios de Casos y Controles , Canal de Potasio ERG1 , Electrocardiografía , Canales de Potasio Éter-A-Go-Go/química , Frecuencia de los Genes , Marcadores Genéticos , Variación Genética , Haplotipos , Humanos , Síndrome de QT Prolongado/diagnóstico , Masculino , Estructura Terciaria de Proteína , Esquizofrenia/tratamiento farmacológicoRESUMEN
We aimed to emphasize which method should be prioritized by comparing the ultrasound and computed tomography (CT) guidance for percutaneous transthoracic biopsy of pleural-based lung lesions in terms of comorbidity, diagnostic success, time, and costs.Approximately 700 biopsy procedures performed between 2014 and 2018 were retrospectively reviewed. The files of these patients and picture archiving and communication system were scanned.Size and localization of the lesion, pathological diagnosis, comorbidity status, pneumothorax complications at the end of the procedure, and whether or not a thoracic tube was placed due to pneumothorax were recorded. Fisher exact test and Pearson χ test were used for statistical analysis.A total of 181 patients who underwent the pleural-based biopsy procedure, the subject of study, were included in the study. One hundred (55.2%) of the biopsy procedures of these patients were performed under the guidance of tomography, and 81 (44.8%) were performed under the guidance of ultrasound (US). Median size of the lesions is 38 mm (25%-75%, 33-55 mm). Pneumothorax complications were observed in 6 patients (6%) who had CT-guided procedures and 4 patients (4.9%) who had US-guided procedures. Of the patients who developed pneumothorax, 2.8% were inserted thoracic tubes owing to the complication. Diagnostic efficacy of our procedures is 99.8% in US-guided procedures and 97% in CT-guided transthoracic biopsy. The average duration of US-guided transthoracic biopsy procedures is 17 minutes, and the average duration of CT-guided biopsy procedures is 35 minutes.
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Biopsia con Aguja/métodos , Enfermedades Pleurales/patología , Radiografía Intervencional , Tomografía Computarizada por Rayos X , Ultrasonografía Intervencional , Adulto , Biopsia con Aguja/efectos adversos , Femenino , Humanos , Masculino , Neumotórax/etiología , Estudios RetrospectivosRESUMEN
The aim of this study was to investigate the relationship between social anxiety and dissociation among male patients with alcohol dependency. Participants were 176 male patients consecutively admitted to an alcohol dependency treatment unit. The Liebowitz Social Anxiety Scale, the Dissociative Experiences Scale, the Beck Depression Inventory, the Spielberger State and Trait Anxiety Inventory, the Michigan Alcoholism Screening Test, and the Symptom Checklist-90-Revised were administered to all participants. The dissociative (N=58, 33.0%) group had significantly higher social anxiety scores than the non-dissociative participants. Patients with a history of suicide attempt or childhood abuse had elevated social anxiety scores compared to those without. In multivariate analysis, dissociative taxon membership predicted both of the two social anxiety subscale scores consisting of fear/anxiety and avoidance in a highly significant level while trait anxiety was a significant covariant for these subscales. Among dissociative symptoms, only depersonalization and amnesia/fugue were predictors of social anxiety. Dissociation and social anxiety are interrelated among alcohol-dependent men. This relationship may have implications for prevention and treatment of alcohol dependency among men with a childhood trauma history in particular.