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Objectives: To investigate the role of diffusion-weighted MRI (DWI) in the diagnosis of urinary bladder (UB) tumours by means of measuring apparent diffusion coefficient (ADC) values. Methods: A total of 83 people aged between 18 and 86 years were included in the study: 63 patients with UB pathology (46 malignant, 17 benign) constituted the case group; 20 individuals without any UB pathology constituted the control group. DWI was applied to all individuals. The ADC values were measured based on the tissue of the UB mass entities and normal UB wall in the control group. Results: The mean ADC value in the UB carcinoma group was significantly lower than that in the control group: 1.0684 ¡ 0.26 6 10 23 mm 2 s -1 and 2.010 ¡ 0.11 6 10 23 mm 2 s -1

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Previous studies have demonstrated a significant association between red blood cell distribution width (RDW) and acute pulmonary embolism. To the authors' knowledge no study has been reported in patients with deep venous thrombosis (DVT). A total of 431 lower extremity venous duplex examinations were included in the study. Of these, 216 examinations with the diagnosis of DVT were compared to 215 examinations with normal duplex findings with respect to RDW. The two groups were well matched. DVT group had a higher median value and the interquartile range (25th and 75th) of RDW (%) level [14.9 (14.2-16.7)] compared to control group [14.4 (13.6-15.2); P < 0.001], respectively. Patients were divided into tertiles based on RDW. DVT was detected in 42 patients (31.6%) in the lowest tertile, in 81 (53.3%) in the middle tertile, and in 93 (63.7%) in the highest tertile (P < 0.001). In multivariate analysis after adjustment for confounding variables, RDW was the only parameter to predict the presence of DVT [odds ratio (OR) 1.37; 95% confidence interval (CI) 1.21-1.55; P < 0.001]. After removing patients with chronic DVT, the interquartile range (25th and 75th) of the RDW (%) level was also higher in the DVT group [15.0 (14.2-16.7)] compared with the control group [14.4 (13.6-15.2); P < 0.001], respectively. In addition, in proximal DVT, the significant difference continued to be present, although this significance was lost in distal DVT [14.4% (13.6-15.2) vs. 16.1% (15.1-17.4), P < 0.001 and 14.4% (13.6-15.2) vs. 14.3% (14.2-14.7), P = 0.959]. In multivariate analysis, RDW was an independent predictor of risk of proximal DVT (OR 1.60; 95% CI 1.39-1.84; P < 0.001). RDW (%) level was significantly higher in patients with bilateral DVT than in patients with unilateral DVT [16.0 (14.8-17.1) vs. 14.4 (14.2-14.8), P < 0.001, respectively]. In receiver operating characteristics curve analysis, RDW more than 14.9% had 85% sensitivity and 73% specificity in predicting proximal DVT. RDW, an inexpensive and easily measurable laboratory variable, was independently and significantly associated with the presence and severity of DVT, especially nonchronic proximal DVT. The mechanism of association requires, however, further study.

Objective:To investigate the existence of depression and/or anxiety with underlying risk factors among parents of children with classical phenylketonuria (PKU).Methods:This cross-sectional study was conducted in the Division of Pediatric Metabolism, Ankara Children’s Hospital, Dokuz Eylul University, Kırıkkale University, and Erzurum Local Research Hospital, Turkey, between January and July 2014. Parents of 61 patients and 36 healthy controls completed the self-report questionnaires. We used Beck Depression Inventory (BDI) to assess the parental depression and State-Trait Anxiety Inventory S-T (STAI S-T) to assess parental anxiety.Results:Depression and anxiety scores were significantly higher in the case group (BDI 12.3±9.1; STAI-S: 38.2±9.6; STAI-T: 43.2±6.9) than controls (BDI: 5.4±4.1 p=0.000; STAI-S: 31.8±7.6 p=0.001; STAI-T: 37.0±7.2 p=0.000). Mothers of the patients had higher scores than the other parental groups (BDI: p=0.000, STAI-S: p=0.001 and STAI-T: p=0.000). Logistic regression analysis showed that low educational level of the parent was the only independent factor for depression (OR 9.96, 95% CI: 1.89-52.35, p=0.007) and state anxiety (OR: 6.99, 95% CI: 1.22-40.48, p=0.030) in the case group.Conclusion:A subset of parents with PKU patients have an anxiety or depressive disorder. Supportive services dealing with the parents of chronically ill children such as PKU are needed in order to reduce the level of anxiety.

• Elastosonography uses colour-maps and strain ratios for evaluating tissue deformability. • Colour change from blue to red and increased strain ratio represent softening. • Normal cartilage shows decreased compressibility, represented by blue colour and low strain ratio. • Pathologic cartilage shows increased compressibility, represented by red colour and high strain ratio. • Elastosonography may be used for differentiating pathologic cartilage from normal cartilage.

Our results indicate that TSE can provide important information that help discriminate between endometrial carcinoma and endometrial hyperplasia.

OZLEM UNAL Dokuz £yJul University, TurkeyThe characteristics, perceptions, attitudes and behaviour of beach users at three locations: St George's Bay, Malta, Mamaia, Romania and Olu Deniz, Turkey, were determined from questionnaire surveys. Respondents comprised locals, domestic ond foreign tourists. Results far these parameters had substantial agreement both across the three beaches and with previous studies. The amounts beach users were willing to pay (WTP), via the contingent valuation method and their consumer surpluses (C5), via the travel cost method were determined. The average amount beach users were willing to pay per visit, was £0.64 on 5t George's bay, £0.32 on Mamaia and £0.94 on Olu Deniz. The willingness to pay varied with social closs, earnings, amount of beach use and between local, domestic and foreign user groups. The consumer surplus also varied for these groups as British tourists had a C5 of £0.62 per visit, with domestic Turkish and Romanian users having values of £0.46 and £0.69, respectively. Diminishing marginal utility, as measured by Wfp, with beach use was found in all three surveys. Charging far actual use would be acceptable for the majority of beach users. Coastal zone managers could realise significant revenues from beach users if they charge adults on a per visit basis (the favaured mode of payment) and spend the revenue on the maintenance and improvements identified by the users. Only one of the beaches (Olu Deniz, Turkey) currently has restricted access, which would facilitate such a payment method.