Susceptibility-Weighted MR Imaging: Added value of susceptibility signals in diagnosis of hemorrhagic lesions of the brain

Susceptibility-weighted imaging (SWI) is a relatively new high-spatial resolution 3D gradient-echo MR imaging technique that uses both magnitude and phase information. This technique exploits the magnetic susceptibility differences of various tissues or substances, such as blood products, iron, and calcification. It is particularly useful to visualize intravascular venous deoxygenated blood as well as extravascular blood products. Therefore, SWI provides additional diagnostic and prognostic data in the evaluation of a wide variety of neurologic disorders including various hemorrhagic lesions seen in traumatic brain injury, coagulopathic or other hemorrhagic disorders, occult vascular malformations, stroke, hypoxic-anoxic injury, neoplasms, and neurodegenerative disorders. We present a review with selected cases to illustrate and discuss the clinical usefulness of SWI in hemorrhagic lesions of the brain

Postspinal baş ağrısı sonrası gelişen ve atipik prezentasyon gösteren posterior reversibl ensefalopati sendromu

Headache is common in the postpartum period. Post-dural puncture head- ache (PDPH) is the most common major complication after spinal anaes- thesia. the clinical features and history of spinal anaesthesia are sufficient for diagnosis. However, the differential diagnosis is extensive and the evaluation of persistent symptoms requires a multidisciplinary approach for diagno- sis and treatment. Here, we report an 31 year-old woman with a history of normal pregnancy, presenting with persistent headache that started on postpartum day 2, and was refractory to conservative therapy of PDPH; the patient developed hypertension, seizures, visual disturbances, and altered mental status on postpartum day 7. the clinical outcome and neuroimaging findings of the patient were compatible with an atypical presentation of pos- terior reversible encephalopathy syndrome (PRES) associated with late post- partum preeclampsia. She showed dramatic improvement with antihyper- tensive therapy. PRES is a frequently reversible acute neurologic entity with different aetiologies including preeclampsia/eclampsia. However, a delay in diagnosis and treatment can result in permanent brain damage and death. Therefore, it is important to recognise atypical clinical and radiological pre- sentations of PRES for early diagnosis and treatment.Doğum sonrası dönemde baş ağrısı sık görülür. Postspinal baş ağrısı (PSBA) spinal anestezi sonrası en çok görülen büyük komplikasyondur. Tanı için klinik tablo ve spinal anestezi öyküsü yeterlidir. Fakat ayırıcı tanı listesi çok geniştir ve devam eden semptomlar varlığında tanı ve tedavi için çok yönlü yaklaşım gerekmektedir. Burada, sorunsuz bir gebeliği takiben postpartum 2. günde başlayan ve PSBA tedavisine yanıt vermeyen inatçı baş ağrısı ve 1. haftada hipertansiyon, görme bozukluğu, konvülziyon ve şuur durumunda bozukluk gelişen 31 yaşında kadın hastayı sunuyoruz. Olgunun klinik gidişi ve nöroradyolojik bulgular ile geç başlangıçlı preek- lampsiye bağlı, atipik prezentasyon gösteren posterior reversibl ensefalopa- ti sendromu (PRES) tanısı konmuştur. Hasta antihipertansif tedavi ile dra- matik iyileşme göstermiştir. PRES preeklampsi/eklampsiyi de içeren farklı etiyolojik etkenlere bağlı ortaya çıkan, çoğu zaman geri dönüşü olan akut bir nörolojik tablodur. Ancak tanı ve tedavide gecikme, kalıcı beyin hasa- rı ve ölüme neden olabilir. Bu nedenle PRES erken evre tanı ve tedavisi açısından atipik klinik ve radyolojik prezentasyonun bilinmesi önemlidir

Pediatricians' COVID-19 experiences and views on the willingness to receive COVID-19 vaccines: A cross-sectional survey in Turkey

Developing an effective and safe vaccine against Covid-19 will facilitate return to normal. Due to hesitation toward the vaccine, it is crucial to explore the acceptability of the COVID-19 vaccine to the public and healthcare workers. In this cross-sectional survey, we invited 2251 pediatricians and 506 (22%) of them responded survey and 424 (84%) gave either nasopharyngeal swap or antibody assay for COVID-19 and 71 (14%) of them got diagnosis of COVID-19. If the effective and safe COVID-19 vaccine was launched on market, 420 (83%) of pediatrician accepted to get vaccine shot, 422 (83%) of them recommended vaccination to their family members, 380 (75%) of them accepted to vaccine their children and 445 (85%) of them offered vaccination to their pediatric patients. Among the participated pediatricians 304 (60%) of them thought COVID-19 vaccine should be mandatory. We found that there are high COVID-19 vaccine willingness rates for pediatricians for themselves, their own children, family members and their pediatric patients. We also found that being a pediatric subspecialist, believing in achieving an effective vaccine, willingness to participate in the phase 1-2 clinical vaccine trial, willingness to get an influenza shot this season, believing a vaccine and vaccine passport should be mandatory were significant factors in accepting the vaccine. It is important to share all information about COVID-19 vaccines, especially effectiveness and safety, with the public in a clear communication and transparency. The opposite will contribute to vaccine hesitancy and anti-vaccine movement

Acute pancreatitis in Turkey: Results of a nationwide multicenter study

Background: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians’ compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real-world practice. Mortality remains high in severe cases and physicians’ adherence to guidelines during management of the disease needs improvement in some aspects