Prognostic Importance of Lymph-Vascular Space Involvement in Stage I Endometrioid Type Endometrial Cancer

Objective:The study aimed to investigate the prognostic significance of lymph-vascular space invasion (LVSI) in patients with stage I endometrioid-type endometrial carcinoma (EC) and to determine its impact on overall survival (OS) and disease-free survival (DFS).Methods:Medical records of 611 patients with stage I endometrioid-type EC who underwent surgery at our Ankara Dr. Zekai Tahir Burak Women's Health Training and Research Hospital Gynecology Clinic were retrospectively analyzed. The patients were divided into two groups based on the presence or absence of LVSI. The primary outcome measures were DFS and OS, and the prognostic significance of LVSI was assessed using univariate and multivariate analyses.Results:We identified 52 LVSI-positive patients among 611 patients with stage I endometrioid EC during the study period; 489 (80%) were classified as stage IA and 122 (20%) as stage IB. The total number of recurrences was 26 (4.3%). LVSI was observed in only 4 patients with recurrence (15.3%). For the LVSI positive patients, the 5-year DFS was 88.7%, whereas the 5-year OS rate was 91.6%. Age >60 years [hazard ratio (HR) 4.08, 95% confidence interval (CI) 1.57-10.59; p=0.004] and tumor size >2.8 cm (HR 2.48, 95%, CI 1.001-6.148; p=0.05) were found to be independent prognostic factors of decreased OS.Conclusion:We found that LVSI in stage I endometrioid-type EC was not a significant predictor of DFS and OS. Patient’s age and tumor size were independent prognostic factors of crude survival. These results suggest that LVSI may not be a useful prognostic marker in this patient population and that further studies are needed to identify more reliable predictors of survival in EC

EVALUATING AGGRESSION LEVELS OF SPORT SPECTATORS

The aim of this study was to examine the aggressiveness levels of the individuals who are in different sports branches and who define themselves as spectators of those sports according to different parameters. Research group of the study is composed of 696 people who live in Ankara and define themselves as spectators of a sports branch. The aggression scale developed by Buss and Perry (1992) was used in the research. The scale is a 5-point Likert-type scale consisting of 29 items. The normal distribution of the data was examined by Skewness (.417) and Kurtosis (.576) tests and normal distribution of the data was determined. In this context, in the analysis of the data, the independent t-test and One Way Anova test were used as parametric tests. Also, the reliability of the data was determined by Cronbach Alpha internal consistency .822. As a result, a rate of aggression of sports spectators has been found in the middle and higher levels. The highest level of aggression sports spectators were found in combat sports and football branches. In addition, the aggressiveness levels of male spectators are higher than those of female spectators. Also, the highest level Sub-Dimension of sports spectators were found in physical aggression Sub-Dimension.  Article visualizations

Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder

Objectives The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA

Evaluation of prioritization methods in child mental health services

Amaç: Bu çalışmanın amacı çocuk ve ergen psikiyatrisi polikliniğine başvuran olgularda öncelik belirleme yöntemlerinin değerlendirilmesidir. Yöntem: Çalışma grubundaki 5-18 yaş arası 900 hasta ve/veya ebeveynlerine Güçler ve Güçlükler Anketi (GGA), Çocuk ve Gençler için Davranış Değerlendirme Ölçeği (ÇDDÖ), Kendini Değerlendirme Ölçeği (KDÖ) formları uygulanmıştır. Hekim, klinik değerlendirmesi sonucunda hastaları yönlendirmiş ve Çocuk Ruh Sağlığı Öncelik Ölçütleri (ÇRSÖÖ) ve Görsel Analog Skala (GAS) formlarını doldurmuştur. Yapılan klinik değerlendirme sonucunda öncelikli olarak izlem planlanan hastalar ile öncelikli olmayan hastaların ölçek puanları karşılaştırılmıştır. Bulgular: Öncelikli olmayanlar ile karşılaştırıldığında (n=649), öncelikli olguların (n=251) ÇDDÖ ve KDÖ problem puanları ve GGA puanları anlamlı düzeyde yüksek, ÇDDÖ Okul yeterlik puanı dışındaki tüm ÇDDÖ ve KDÖ yeterlik puanları anlamlı düzeyde düşük bulunmuştur. Çalışma grubundaki olguların ÇRSÖÖ ve GAS puanları arasında çok güçlüæ ÇRSÖÖ ve GAS puanları ile GGA, ÇDDÖ ve KDÖ problem puanları arasında orta derecede anlamlı pozitif korelasyon saptanmıştır. Değişik kesim noktalarında ÇRSÖÖ ve GAS puanları hekim yönlendirmeleriyle orta derecede tutarlı bulunmuştur. ÇRSÖÖ ve GAS'ın ‘öncelikli' yönlendirilmeyi öngörme gücünün yüksek olduğu saptanmıştır. Sonuç: ÇRSÖÖ'nün nesnel bir değerlendirme yöntemi olarak klinik değerlendirmeyi destekleyebileceği düşünülmüştür. Anahtar kelimeler: Çocuk ve ergen psikiyatrisi, Öncelik değerlendirmesi, Görsel Analog Skala Aim: This study aims to evaluate prioritization methods in patients who consult child and adolescent psychiatry clinics. Method: Strengths and Difficulties Questionnaire (SDQ), Child Behaviour Checklist (CBCL), and Youth Self Report (YSR) forms were filled out by 900 patients of age 5 to 18 and/or their parents. After triage assessments, the attending clinician filled out Children's Mental Health Priority Criteria Tool (CMHPCT) and Visual Analogue Scale (VAS). Scales scores of the patients in need of an urgent appointment as identified through the triage were compared with those of non-urgent ones. Results: When compared with the non-urgent ones (n=649), the CBCL and YSR problem scores and SDQ scores of the urgent patients (n=251) were found to be significantly higher, while all the CBCL and YSR competence scores except CBCL school competence score were found to be significantly lower. A very high positive correlation was determined between the CMHPCT and VAS scores of the patients in the study, while a significant moderate correlation was found between CMHPCT and VAS scores and SDQ, CBCL, and YSR scores. CMHPCT and VAS scores were found moderately consistent with clinician categorizations at different cut-off points. CMHPCT and VAS scores have high predictive power on categorization of cases as urgent. Conclusion: It was concluded that CMHPCT may support clinical assessments as an objective assessment method. Keywords: Child and adolescent psychiatry, Priority evaluation, Visual Analogue Scal

Aripiprazole Used to Treat Capgras Syndrome in an Adolescent Diagnosed With Autism

ObjectivesThis report discusses the emergence, clinical appearance, and treatment of the rare entity Capgras syndrome (CS) in an adolescent diagnosed with autism.MethodsAfter a brief introduction to the CS, we conduct a detailed description of the case and review, after a search on the PubMed database, the known pathophysiology, psychiatric disorders associated with the onset of this syndrome, and the management of CS.ResultsCapgras syndrome generally emerges during the course of delusional disorder, schizophrenia, or mood disorders, and for reasons such as neurological, infectious, or endocrinological diseases, drug intoxications, or deprivation. We encountered no previous reports of CS developing during the course of autism. There are no prospective studies concerning the treatment of the syndrome. However, antipsychotic drug use is primarily recommended in treatment. Antipsychotic drug therapy was therefore planned for the treatment of delusion, a psychotic symptom, in this case. The atypical antipsychotic aripiprazole was used based on the presence of accompanying diagnosis of autism, and the patient's body mass index and age. A relatively high dose of aripiprazole was required for the first psychotic attack in our patient. However, a good level of response was achieved within the expected time frame. In addition, no marked adverse effects were observed.ConclusionsAripiprazole seems to be an effective and well-tolerated antipsychotic drug in the treatment of CS accompanying autism