Substance Initiation Tendency Scale (SITS): Validity and Reliability Study.

Background: The purpose of the present study was to make a new contribution to the literature by developing a scale to detect the substance initiation tendencies of young people and adolescents and to create a leading tool for preventive policies to be implemented against substance use. Method: An 8-item and 2-factor measurement tool called the "Substance Initiation Tendency Scale" was created. The data obtained from 470 students studying in 5 high schools in the Genç County of Bingöl, Turkey, were subjected to reliability and validity tests. In this context, Explanatory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), item analysis, and halving methods were used along with the SPSS 24 and AMOS 24 data analysis programs. Results: It was found that the Kaiser-Meyer Olkin (KMO) value was "excellent" with .909 and the Bartlett Sphericity Test was significant, and the scale, which could explain 57.332% of the total variance, had the feature of distinguishing what was intended to be measured. The values obtained from the Confirmatory Factor Analysis showed a "good fit". Conclusion: It was understood that the obtained data were sufficient to confirm the construct's validity.

Pediatric emergency department visit characteristics of the patients on the ketogenic diet.

BACKGROUND: The ketogenic diet (KD) has been frequently used for the patients with drug-resistant epilepsy in recent years. The management of these patients in emergency departments (EDs) has some difficulties due to the special needs of KD. We aimed to determine the characteristics and the management of the patients on the KD in the pediatric ED setting. METHODS: Patients who were on the KD and admitted to the ED were included in the study. Demographic, clinical, and laboratory data of all patients were retrospectively reviewed and recorded. RESULTS: There were 105 emergency admissions of 27 patients. The median age of all patients was 55.0 (IQR: 29.0-91.0) months. The most common symptom was vomiting (43.8%). Four patients had upper gastrointestinal bleeding, and one patient had hyperammonemic acute hepatic failure while receiving KD. Of the patients, 41.9% had seizure-related ED admission. Infections were present in 41.9% of the ED visits. The frequency of status epilepticus was significantly lower in the patients who were on the KD for more than 6 months (p < 0.01). In 42.9% of all ED admissions, dextrose containing maintenance fluids was administered mistakenly; although ketosis rate was lower, no seizure was observed in this group. CONCLUSION: The patients on the KD can be admitted to EDs with intercurrent illnesses or adverse effects of the KD. For accurate management, emergency physicians must be aware of the common reasons for ED admission of these patients and the effects of the KD.

Cervical Thymic Cyst Around Hypoglossal Nerve.

Cervical thymic cyst is rare lesions leading to cervical mass. As it is a rare entity, it might be confused with other congenital neck masses or neoplastic lesions. Preoperative diagnosis is almost impossible. In the present study, a patient who was operated with prediagnosis of branchial cyst and diagnosed with thymic cyst according to the histopathologic examination was presented. A 16-month-old girl was admitted to our clinic with the complaint of growing right neck mass that was realized about 4 months ago. Magnetic resonance imaging (MRI) of the neck demonstrated a rim-enhanced hypointense cystic lesion in the posterior aspect of the submandibular gland, without tracheal right lateral and mid plane on MRI, curving common carotid artery to the medial. Patients underwent surgery under general anesthesia in company with existing findings. Hypoglossal nerve was surrounded by the mass, and the mass was totally resected. The final pathology result was reported as thymic cyst. Cervical thymic masses might be unnoticed in the differential diagnosis of the cervical mass as they are rarely seen entities. Histopathologic examination of the thymus tissue was performed for diagnosis. Surgical excision is the ideal treatment approach and no postoperative recurrence has been reported.

Transcription factor 4 gene rs9960767 polymorphism in bipolar disorder.

The transcription factor 4 (TCF4) gene encodes a helix-loop-helix transcription factor protein, which initiates neuronal differentiation and is primarily expressed during nervous system development. The aim of the present study is to investigate the association of the TCF4 rs9960767 polymorphism and bipolar disorder, which is highly heritable. DNA isolation was performed on 95 patients with bipolar disorder and 108 healthy control subjects to examine the TCF4 rs9960767 polymorphism. Genotypic and allelic frequencies were determined using the polymerase chain reaction-restriction fragment length polymorphism method designed in our laboratory. Statistical analysis was performed using χ2 test within the 95% confidence interval. Odds ratios were calculated and Hardy-Weinberg equilibrium (HWE) was verified for all control subjects and patients. The A allele frequency was 95.8% in the patients and 94.4% in the control subjects, and 4.2% in the patients and 5.6% in the control subjects for the C allele. The genotype frequencies of the TCF4 gene rs9960767 variant were as follows: AA, 91.6% and AC, 8.4% in patients with bipolar (CC genotype was not observed in cases); AA, 89.8%; AC, 9.3% and CC, 0.9% in the control subjects. No statistically significant difference was identified between the patients and control subjects (χ2=0.937; P=0.626). In addition, gender specific analysis was performed, although no significant association was found according to the gender distrubition. All patients and control subjects were in HWE (P>0.05). Statistical analysis of the data indicates that the TCF4 gene rs9960767 polymorphism is not an independent risk factor for bipolar disorder in the overall population or in terms of gender; however, an increased population size would improve the statistical power. Furthermore, additional gene variants that are specifically involved in neuronal development may be analyzed for revealing the complex genetic architecture of bipolar disorder. An improved approach would be better to evaluate the TCF4 gene in a pathway specific manner due to its role as a transcription factor.

Association of nicotinamide-N-methyltransferase (NNMT) gene rs694539 variant with bipolar disorder.

Here we report the association of the rs694539 variant of nicotinamide-N-methyltransferase gene with bipolar disorder in a case-control study of 95 bipolar disorder patients and 201 healthy controls (χ(2)=13.382, P=0.001). With the polymerase chain reaction restriction fragment length polymorphism method we developed we were able to show the association for the first time. This new finding may provide evidence to understand the mechanism of the disease.

[General practitioners' attitudes towards psychotic disorders and their treatment in the primary health care system]. / Birinci basamak saglik hizmetlerinde calisan pratisyen hekimlerin psikotik bozukluklar ve tedavisine yönelik tutumlari.

OBJECTIVE: To assess general practitioners' attitudes and behavior towards psychotic disorders, antipsychotic drug prescriptions, and patients with psychosis in primary health care settings. METHOD: 262 general practitioners (GPs) practicing in primary care settings in Kocaeli province were included in the study. The 20-item questionnaire, which was prepared by the researchers, was sent to all GPs via the Kocaeli branch of the Health Ministry. 195 (74.4%) questionnaires were returned. The GPs' responses and the relations between different variables were examined. RESULTS: The participation rate among GPs in any education about psychosis and antipsychotic treatment after graduation was 27.2%. The rate seeking structured and advanced education about psychosis was 41.0%. The mean daily number of patients with psychosis examined by GPs in primary care settings during the previous six months was 1.4. They first prescribed any antipsychotic drug by themselves at a rate of 12.8% in the previous six-month. The most frequent reason for antipsychotic prescription was re-prescription (80.0%). The most frequent problem in the pharmacological treatment of psychotic disorders was the drop-out rate of patients (75.9%). The predictors of starting patients with psychosis on medication were the belief that the patients were treatable in primary care and the suspicion of GPs about psychosis. CONCLUSION: GPs practicing in primary care settings rarely encounter patients with psychosis. GPs mostly avoid undertaking the responsibility of treating them. However, some are eager to participate in structured education about psychosis in order to have more confidence when diagnosing and treating it.

[An Experience of a Clubhouse run by Families and Volunteers for Schizophrenia Rehabilitation]. / Sizofreni rehabilitasyonunda aile ve gönüllülerle yürütülen bir kulüp-ev denemesi.

OBJECTIVE: To test the efficacy of a non-governmental psychosocial rehabilitation program (Psychosocial Rehabilitation Clubhouse), which was developed by the authors and thought to be easy to put into practice for patients with schizophrenia. METHOD: Patients with schizophrenia (n: 14) were serviced at "Izmit Our Garden Solidarity Foundation of Families of Patients with Schizophrenia" for 8 months. Rehabilitation services were conducted wholly by families and volunteers, and run by a volunteer psychologist. Program included daily activities, cultural, leisure and social activities, one day in a week. Patients were assessed by using the Quality of Life Scale (QLS), Social Functioning Scale (SFS), Global Assessment Scale (GAS), and Positive and Negative Syndrome Scale (PANNS) at baseline and at the end of the study. RESULTS: All patients (n:14) completed the program with 73% mean presence in the activities. Increase of the social functioning and the good clinical outcome was observed in patients. The results of the scales were as follows: SFS at baseline 105.1+/-20.6, in the end 133.7+/-17.1, (p<0.001); GAS at baseline 53.4+/-10.5, in the end 66.0+/-8.1, (p<0.001); QLS at baseline 62.8+/-17.4, in the end 93.4+/-19.8, (p<0.001); and PANSS in the baseline 70.3+/-16.9, in the end 61.9+/-16.5, (p<0.002). CONCLUSION: Psychosocial clubhouse rehabilitation program run by patients' families and volunteers in a small foundation environment, which is the first trial in Turkey, has been carried out successfully.