Diagnostic Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Evaluation of the Biliary Obstruction

Purpose. In this study, our purpose was to investigate the diagnostic efficacy of the dynamic contrast-enhanced magnetic resonance imaging (MRI) method in the patients with bile duct obstruction. Materials and Methods. 108 consecutive patients (53 men, 55 women, mean age; 55.77 ± 14.62, range 18–86 years) were included in this study. All the patients underwent conventional upper abdomen MRI using intravenous contrast material (Gd-DTPA) and MRCP in 1.5 Tesla MRI scanner. MRCP images were evaluated together with the T1 and T2w images, and both biliary ducts and surrounding tissues were examined for possible pathologies that may cause obstruction. Results. MRI/MRCP findings compared with final diagnoses, MRI/MRCP in the demonstration of bile duct obstruction sensitivity 96%, the specificity 100%, and accuracy 96.3%, in the detection of presence and level of obstruction, the sensitivity 96.7%, specificity 100%, and accuracy 97.2%, in the diagnosis of choledocholithiasis, the sensitivity 82.3%, specificity 96%, and accuracy 91.7%, and in the determination of the character of the stenosis, sensitivity 95.6%, specificity 91.3%, and accuracy 94.5% were found. Conclusion. The combination of dynamic contrast-enhanced MRI and MRCP techniques in patients with suspected biliary obstruction gives the detailed information about the presence of obstruction, location, and causes and is a highly specific and sensitive method

Practice of Acute and Maintenance Electroconvulsive Therapy in the Psychiatric Clinic of a University Hospital from Turkey: Between 2007 and 2013

Objective: Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years' observation with acute and maintenance ECT in a university hospital in Turkey. Methods: The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered psychotropic drugs were recorded. The frequency of ECT was calculated by identifying the total number of the hospitalized patients during the study period from the hospital records. Results: A total number of 1,432 female and 1,141 male patients hospitalized in a period of 7 years, with a total number of 111 patients treated with ECT. The ratio of ECT was 4%, maintenance/acute ECT 11%. For acute ECT, affective disorders (65.3%) and psychotic disorders (21.6%) were among the leading diagnoses. Maintenance ECT, the diagnosis was; 6 affective disorders, 4 psychotic disorders and 1 obsessive compulsive disorder. There was a significant difference between the patients receiving acute and maintenance ECT in terms of age, duration of illness, and number of previous hospitalizations and ECTs. Conclusion: The percentage of patients treated with acute ECT is lower in our institution than that in many other institutions from our country. Acute and maintenance ECT should be considered as an important treatment option particularly for patients with long disease duration, a high number of hospitalizations and a history of benefiting from previous ECTs. Copyright © 2016, Korean College of Neuropsychopharmacology

MRI assessment of chronic pancreatitis

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Magnetic resonance imaging (MRI) plays an important role in the assessment of chronic pancreatitis. By standard MRI techniques, decreased parenchymal signal on T1-weighted fat-suppressed images and delayed gradual enhancement on serial contrast enhanced images represent fibrotic changes caused by chronic inflammation. Magnetic resonance cholangiopancreaticography (MRCP) can reveal ductal changes, including side branch ectasias, that are related to tissue fibrosis and destruction. The exocrine function of the gland and an increased number of side branch ectasias can be evaluated with secretin-stimulated MRCP. Diffusion weighted imaging is an emerging technology that can complement standard MRI to assess the parenchymal changes associated with chronic pancreatitis. The same technique can also quantify the parenchymal response to secretin stimulation. This article reviews standard imaging techniques and new advancements in MRI technology as they relate to the assessment of chronic pancreatitis

Psychometric properties of a Turkish version of the oral health impact profile-14

WOS: 000391533800004PubMed ID: 27958241Objectives: The purpose of this study was to analyze and evaluate a Turkish translation of the oral health impact profile-14 (OHIP-14) in a Turkish population to provide an objective standard for future studies. Methods: This cross-sectional research study consisted of three independent studies. Data were collected utilizing a personal interview and a review of periodontal records. This study was performed on 1205 subjects who were visiting for routine medical check-ups. The OHIP-14 was administered to measure oral health related to the quality of life, along with a questionnaire addressing demographic information, such as age, gender, and education. Results: The reliability coefficient (Cronbach's alpha) of the Turkish version OHIP-14-TR (OHIP-14-TR) was reported to be nearly perfect in all 3 parts of our study (alpha 1: 0.82; alpha 2: 0.76; alpha 3: 0.91); additionally, values were greater than the recommended 0.70 threshold. Spearman's correlation coefficients showed that both OHIP scores significantly correlated with periodontal parameters, serving as proof of convergent validity (P < 0.01, P < 0.001). The principal component analysis with varimax rotation revealed seven factors. The OHIP-14-TR was more than 95% comprehensible. Conclusion: The OHIP-14-TR is a reliable, valid, and comprehensible scale for measuring oral health-related quality of life in the Turkish population

Aripiprazole induced mania

Aripiprazole, a new antipsychotic drug is commenly used in treatment of schizophrenia and bipolar disorder. Although all new generation antipsychotics were used in treatment of bipolar disorder, they could also induce mania in some cases. We present a case of aripipazole induced mania. K.K. is a 19 years old woman without history of bipolar disorder. Acute maniac episode occurred in her after using aripiprazole 30mg/day. Her episode ended after discontinuation of aripiprazole and administration of quetiapine 900mg/day, Na-valproat 1500mg/day, lorazepam 5mg/day. Clinicians might consider that aripiprazole might induce mania in some cases

A Case of Tourette Syndrome: Response To Aripiprazole Treatment

Tourette&apos;s disorder is a neuropsychiatric syndrome that manifests with motor and vocal tics. Antipsychotics, especially pimozide and haloperidol have been used in treatment of Tourette&apos;s disorder for a long time. In recent studies, it was reported that second generation antipsychotics have been successfully used to treat Tourette&apos;s disorder. In this article we present a report of successful treatment of tics with aripiprazole in a patient with Tourette&apos;s disorder

Dermatologic adverse effects associated with antidepressants: Presentation of two cases

Many drugs may cause skin reactions, but skin reactions are seen more commonly with psychotropic drugs. Dermatologic adverse effects have increased because use of antidepressant drugs have become more common all over the world. Most of these adverse effects are benign reactions but rarely serious adverse skin reactions might occur due to antidepressant drugs. There were several case reports about dermatologic side effects of antidepressants in the literature. We present two more cases of adverse skin reactions due to antidepressants; a case of erythema multiforme due to bupropion and a case of acute urticaria due to escitalopram

Added Value of Contrast Medium in Whole-Body Hybrid Positron Emission Tomography/Magnetic Resonance Imaging: Comparison between Contrast-Enhanced and Non-Contrast-Enhanced Protocols.

To compare the diagnostic ability and time efficiency of contrast-enhanced (CE) whole body fluorodeoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) protocol and non-CE (NCE) protocol