Influence of Obesity on Bone Mineral Density in Postmenopausal Asthma Patients Undergoing Treatment with Inhaled Corticosteroids

OBJECTIVES: The etiology of osteoporosis in asthma is complex as various factors contribute to its pathogenesis. The purpose of our study was to investigate the effects of obesity and inhaled steroids, as well as the severity and duration of asthma, on osteoporosis in postmenopausal asthma patients as compared to healthy controls. METHODS: A total of 46 patients with asthma and 60 healthy female controls, all postmenopausal, were enrolled in our study. Bone mineral density was assessed at the lumbar spine and hip using a Lunar DPX-L densitometer. RESULTS: Bone mineral density (BMD) scores were comparable between the asthmatic and control groups, with average scores of 0.95 ± 0.29 and 0.88 ± 0.14 g/cm², respectively. Likewise, osteoporosis was diagnosed in a similar percentage of patients in the asthmatic (39.1%) and control (43.3%) groups. Bone fracture was identified in four patients with asthma (8.6%) and in six patients from the control group (10%). We could not detect any relationship between BMD and duration of asthma, asthma severity, inhaled steroids or body mass index (BMI). There was no difference between the two groups with respect to age or years since menopause. Although asthma patients were more likely to be overweight and presented higher BMD scores on average than the control subjects, these differences were not statistically significant. CONCLUSIONS: There is a slight positive protective effect of high BMI against osteoporosis in asthma patients, but this effect is overcome by time and menopause status. Therefore, the protective effect of obesity against osteoporosis in asthma patients seems to not be significant

Rasch Analysis Of The Neck Bournemouth Questionnaire: Turkish Version, Validity, And Reliability Study

Background/aim: The multidimensional evaluation of patients with chronic neck pain is important for planning the treatment program. The aim of this study was to investigate the validity and reliability of the Turkish version of the Neck Bournemouth Questionnaire (NBQ). Materials and methods: The internal construct validity of the NBQ was examined by the fit of the data to the Rasch measurement model. External validity of the NBQ was evaluated by testing for expected associations of Rasch transformed NBQ score with the corresponding variables through the process of convergent validity. The reliability of the NBQ in terms of both internal consistency and test-retest reliability was assessed by the person separation index (PSI) and differential item functioning (DIF) by time effect. Results: It was determined that the questionnaire has 2 factors. None of the items of Factor 1(F1) and Factor 2 (F2) showed DIE The reliability of F1 (Cronbach's alpha = 0.89, PSI = 0.87) and F2 (Cronbach's alpha = 0.77, PSI = 0.87) was good with Cronbach's alpha and PSI. there was a good correlation between NBQ/E1 and the Neck Disability Index (NDI) (r = 0.673) and Neck Pain and Disability Scale (NPDS) (r = 0.709). Also, there was a correlation between NBQ/E2 and the Beck Depression Inventory (BDI) (r = 0.552) and Beck Anxiety Inventory (BAI) (r = 0.410). Conclusion: The Turkish version of the Neck Bournemouth Questionnaire is valid and reliable.WoSScopu

Development And Psychometric Testing Of The Turkish Immunosuppressive Medication Adherence Scale

Objective: The monitoring of immunosuppressive medication adherence is an important issue for solid organ transplant patients. In Turkey, there has been no valid and reliable measurement tool specific to transplantation for evaluation of medication adherence. The aim of this methodological study was to develop and psychometrically test Immunosuppressive Medication Adherence Scale. Materials and Methods: The Immunosuppressive Medication Adherence Scale was developed, and its validity and reliability were examined using data from 200 solid organ transplant patients. An expert panel evaluated the content validity, and factor analysis was used to evaluate the construct validity. Internal consistency analysis was performed to evaluate the reliability of the scale, and item-total correlations were evaluated. Results: As a result of exploratory factor analysis, all 11 items were found to be collected in a single dimension, and factor loadings varied between 0.32 and 0.87. All scale items had a good positive significant correlation with the total scale score. Content validity was evidenced by obtaining the views of 13 experts (0.80 content validity index). Cronbach's a was 0.61. Conclusion: The Immunosuppressive Medication Adherence Scale has acceptable internal consistency, good content, and construct validity. The scale is appropriate for use in clinical practice settings and research to evaluate immunosuppressive medication adherence of solid organ transplant patients.Wo

A study on the standard setting, validity, and reliability of a standardized patient performance rating scale – student version

The quality of the performances of standardized patients plays a significant role in the effectiveness of clinical skills education. Therefore, providing standardized patients with constant feedback is essential. It is especially important to get students’ perspectives immediately following their encounters with standardized patients. In the literature, there is no scale for use by students to evaluate the performance of standardized patients. Thus, the three main goals of this study were to: (1) develop a scale for use by students to evaluate the performance of standardized patients, (2) examine the psychometric properties of the scale, and (3) determine a cut-off score for the scale in a standard-setting Seven hundred and two medical students participated in the scale- development process, the pilot test, and the validation process, and seven educators took part in the standard-setting process. After the evaluation of content validity, construct validity was assessed via exploratory and confirmatory factor analyses. For the standard-setting study, the extended Angoff method was used. The exploratory factor analysis revealed that the scale had a single-factor structure, which was confirmed by confirmatory factor analysis. The Cronbach’s alpha internal consistency coefficient was 0.91. The scale consists of nine items. The cut-off score was determined to be 24.11/45, which represents the minimum acceptable standard for standardized patient performance. Our study outlined the critical steps in developing a measurement tool and produced a valid and reliable scale that allows medical students to assess the performance of standardized patients immediately following their interaction with the standardized patient. This scale constitutes an important contribution to the literature as it provides a tool for standardized patient trainers to assess standardized patients’ weaknesses and help them improve their performance.KEY MESSAGESEvaluation of SP performance is essential to ensure the educational quality of clinical skills training programs.Students are the most relevant stakeholders to give feedback about SP performance immediately after encounters.The ‘Standardized Patient Performance Rating Scale – Student Version’ is a valid, reliable scale that can be used by students for the evaluation of standardized patients’ strengths and weaknesses at individual-performance levels quickly. Evaluation of SP performance is essential to ensure the educational quality of clinical skills training programs. Students are the most relevant stakeholders to give feedback about SP performance immediately after encounters. The ‘Standardized Patient Performance Rating Scale – Student Version’ is a valid, reliable scale that can be used by students for the evaluation of standardized patients’ strengths and weaknesses at individual-performance levels quickly.</p

One misfortune is better than thousands of pieces of advice: the warning role of rectal bleeding

Objective: Rectal bleeding is one of the most important symptoms of colorectal cancer that fast-tracks the patients consultation with a physician. This study aims to assess the warning role of rectal bleeding in a risk group for colorectal cancer. Besides, the relationship among awareness, various socio-demographic criteria and the reasons for visiting or not visiting the physician was evaluated among greater than or equal to 40 years old. Methods: This descriptive study was conducted thousand one hundred and sixteen (1116) individuals greater than or equal to 40 years old. Awareness of rectal bleeding as a warning sign in participating individuals was assessed by a questionnaire in addition to their family history of cancer or polyps and reasons for visiting or not visiting a physician. Results: A prior history of rectal bleeding was found in 51.9% of subjects. Among those with rectal bleeding history, the rate of visiting a physician due to this bleeding was 49.7%. No statistically significant relationship was found between the frequency of those who contacted their physician and gender, education or age. The frequency of visiting a physician was significantly higher among individuals with a family history of colorectal cancer as compared with no family history and was directly proportional to the degree of family relationship (p = 0.007). Conclusion: Even rectal bleeding does not raise enough attention for visiting a physician. Therefore, public education and screening still have paramount importance in the prevention of colorectal cancer. [Arch Clin Exp Surg 2019; 8(1.000): 15-20

Glofitamab in relapsed/refractory diffuse large B-cell lymphoma: Real-world data

Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study

Current Statement of Intensive Care Units in Turkey: Data obtained from 67 Centers

OBJECTIVES: We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study