The relationship between burnout and work engagement levels of nurses and physiotherapists working during the COVID-19 pandemic period.

BACKGROUND: The COVID-19 pandemic has affected all health professionals worldwide. This has also influenced their working lives, affecting burnout and work engagement. OBJECTIVE: This study aims to investigate the relationship between burnout and work engagement among nurses and physiotherapists during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted with total 509 nurses and physiotherapists who were working at any of the private, public, or university hospitals from two large and one small cities. A Personal Introduction Form, the Maslach Burnout Scale, and the Work Engagement Scale were used in the study. Frequency, percentage, mean, and Pearson correlation analysis were used for statistical analysis. Necessary ethical approvals were taken for the research. RESULTS: There was a significant, moderate, negative relationship between the average scores of the nurses on the vigor and devotion dimensions and the Work Engagement Scale and their average scores on emotional exhaustion, personal accomplishment, depersonalization dimensions and their average score on the Maslach Burnout Scale (p <  0.05). There was a significant, moderate, negative relationship between the scores of the physiotherapists on the Work Engagement Scale and its dimensions and their average scores on the Maslach Burnout Scale and its dimensions (p <  0.05). CONCLUSION: In our study, it was found that the burnout levels of nurses and physiotherapists had an effect on their work engagement during the COVID-19 pandemic. During and after the COVID-19 process, managers should take measures to reduce the burnout levels of health professionals and increase their level of work engagement.

Views of Women's Sexuality and Violence Against Women in Turkey: A Cross-Sectional Investigation Among University Students.

PURPOSE: This study explored Turkish university students' views of women-related issues--gender roles, sexuality, and violence against women. METHOD: A cross-sectional study was conducted with 605 students--337 females and 268 males--at Ankara University, Turkey. A survey exploring students' views of female sexuality and violence was used. Comparisons of responses were made among groups based on sex, year of study at the university, and field of study at the university. RESULTS: Three relevant findings were found: male students had more traditional, nonegalitarian approaches toward women's issues than female students; educational levels and fields of study did not significantly influence students' views of women; and a small percentage of students approve of violence against women. DISCUSSION: These results show that patriarchal values in Turkish society influence the formation of students' opinions, and university education alone cannot affect everyone's views of gender roles, women's sexuality, and violence against women.

Volatile sulphur compound levels and related factors in patients with chronic renal failure.

AIMS: To analyse specific volatile sulphur compound(VSC) levels in a group of chronic renal failure (CRF) patients and determine the relationship between these VSC levels and organoleptic measurements, blood urea nitrogen (BUN) levels, dental and periodontal conditions, salivary flow rate, and tongue coating scores. MATERIALS AND METHODS: One examiner performed organoleptic and VSC measurements on fifty patients with CRF before and after haemodialysis (HD) and controls. DMFT and CPITN indexes, tongue coating scores, salivary flow rates were measured. Comparisons were performed using the Mann-Whitney U, Wilcoxon signed-ranks, and chi-square tests. Spearman correlation coefficient was used to analyse correlations. RESULTS: Before HD, the mean dimethyl sulphide level was 1.04 ± 1.20 in the CRF patients and 0.51 ± 0.65 in controls, with a significant difference. The mean hydrogen sulphide, methyl mercaptan and dimethyl sulphide levels in CRF patients were 1.47 ± 3.04, 1.03 ± 1.85, and 1.04 ± 1.20, respectively, before HD; and 0.53 ± 1.65, 0.48 ± 1.27, and 0.56 ± 0.85, respectively, after HD; with the differences being significant. Methyl mercaptan levels increased with an increase in HD duration. Tongue coating and organoleptic measurements were significantly correlated with methyl mercaptan. CONCLUSIONS: Dimethyl sulphide is the main VSC in extraoral blood-borne halitosis; but methyl mercaptan may also contribute to this type of halitosis. A decreased salivary flow rate and an increased pH of the biofilm matrix may be a significant parameter for VSC levels in CRF patients.

Diagnostic value of T1-weighted gradient-echo in-phase images added to MRCP in differentiation of hepatolithiasis and intrahepatic pneumobilia.

OBJECTIVE: The purpose of this article is to determine the added diagnostic value of T1-weighted gradient-echo in-phase images obtained during MRCP in the detection and differentiation of hepatolithiasis and intrahepatic pneumobilia. MATERIALS AND METHODS: Intrahepatic bile ducts in 47 patients were scored in terms of their possibility of containing biliary stone and air. MRI was performed with a 1-T system for 32 patients and with a 3-T system for 15 patients. Two radiologists independently reviewed two sets of MRI scans: set 1 included T2-weighted MRCP images, and set 2 included T2-weighted MRCP images plus T1-weighted gradient-echo in-phase images. The diagnostic performances of set 1 and set 2 in the evaluation of the bile ducts containing air or stone and bile ducts containing neither of them were analyzed using the area under the receiver operating characteristic curve (AUC) for clustered data. The sensitivities and specificities of both image sets to detect intrahepatic stone or air were also calculated and compared. RESULTS: For the diagnosis of hepatolithiasis, the AUC obtained from set 2 (0.983) was significantly higher than that obtained from set 1 (0.879; p = 0.037). For the diagnosis of pneumobilia, the AUC obtained from set 2 (0.965) was also significantly higher than that of set 1 (0.765; p = 0.002). With use of percutaneous transhepatic cholangiography, ERCP, and CT as the reference standards, the sensitivity of set 2 (97.1%; 95% CI, 91.1-100%) was significantly higher than that of set 1 (74.3%; 95% CI, 56.7-91.9%) in detecting intrahepatic stones (p = 0.011). For the detection of pneumobilia, the sensitivity of set 2 (98.5%; 95% CI, 95.4-100%) was also significantly higher than that of set 1 (70.8%; 95% CI, 57.7-83.3%; p = 0.000). CONCLUSION: The addition of T1-weighted gradient-echo in-phase images to standard MRCP sequences improves the detection and differentiation of hepatolithiasis and intrahepatic pneumobilia.

Vitamin E effect on controlled ovarian stimulation of unexplained infertile women.

PURPOSE: To determine Vit E effect on the treatment outcomes of women with unexplained infertility undergoing controlled ovarian stimulation and intrauterine insemination (IUI). METHODS: The study group (Group A, n053) underwent controlled ovarian stimulation with clomiphene citrate with Vit E administration, 400 IU/day p.o. while the control group(Group B, n050) underwent ovulation induction without VitE. Treatment outcomes were compared between the groups. RESULTS: There were no significant differences between the two groups with respect to the demographic outcomes. The difference in endometrial thickness on the day of hCG administration was significant between the two groups (p00.001).The effect of receiving Vit E on the implantation and the on going pregnancy rates were assesed Odds Ratio (OR) and corresponding 95% Confidence Intervals (CI). Receiving Vit E was not significantly associated with the implantation and the ongoing pregnancy rates; OR 0 1.22, 95% CI (0.44­3.4)and OR 0 1.43, 95% CI (0.49­4.1), respectively. CONCLUSION: Vit E administration may improve the endometrial response in unexplained infertile women via the likely antioxidant and the anticoagulant effects. It may also modulate the antiestrogenic effect of clomiphene citrate and the problem of a thin endometrium in these cycles may beadjusted

A comparison of peripheral marginal bone loss at dental implants measured with conventional intraoral film and digitized radiographs.

The purpose of the present study was to examine the effects of conventional and bone-condensing implantation techniques and time (6 and 12 months after implantation) on levels of marginal bone surrounding implants and to assess the level of agreement between measurements made using digitized intraoral images and film. The study group consisted of 14 healthy patients (9 female, 5 male; age range, 23-59 years; mean age, 41.1 years) with 28 single-tooth dental implants. In each patient, an implant was placed on one side using a conventional technique and on the opposite side using a bone-condensing technique. Film radiographs were taken at 6 and 12 months following implant placement and were digitized at 300 dpi and 600 dpi using a laser scanner. All scanned images were stored as both TIFF and JPEG files. A single observer twice measured distal and mesial marginal bone loss from film and digitized images. At the mesial site, there was a significant main effect of time (6 and 12 months after implantation) on the measurement of bone loss, F(1, 26) = 6.08, P = .02, but no significant main effect of implantation technique, F(1, 26) = 1.56, P = .223, and no significant interaction between time and technique, F(1, 26) = 2.09, P = .160. Similarly, at the distal site, there was a significant main effect of time on the measurement of bone loss, F(1, 26) = 14.1, P = .001, but no significant main effect of implantation technique, F(1, 26) = 1.21, P = .281. However, in contrast to the mesial site, there was also significant interaction between technique and time on the distal site, F(1, 26) = 4.974, P = .035. Intraobserver intraclass correlation coefficients and repeatability measurements showed high agreement for all image types. The bone-condensing technique resulted in greater marginal bone loss. Marginal bone measurements made using digitized intraoral images and conventional film showed high levels of agreement.

The experiences of violence and occupational health risks of sex workers working in brothels in ankara.

OBJECTIVE: The aim of this study was to reveal and discuss occupational health risks, violence against sex workers working in brothels and their working conditions in Ankara. MATERIALS AND METHODS: The study included 138 sex workers. Data were collected at face to face interviews with a questionnaire composed of 40 questions about socio-demographic features, familial characteristics, reasons for becoming a sex worker, experiences of violence and occupational health risks. RESULTS: Twenty-two point five percent of the women were aged 21-30 years and 39.9% were aged 31-40 years. The mean time of education was 5.9±3.5 (0-14) years. Forty-eight point five percent of the women were exposed to physical abuse and 13% of the women had been exposed to sexual abuse in their childhood. Fifty-five point eight percent of the women reported that their clients always used condoms, but 97.1% of the women noted that their clients insisted on not using a condom. Fourteen point five percent and 70.3% of the women were exposed to physical and verbal violence respectively from their clients. Ten point one percent of the women suffered sexual assault while working. CONCLUSION: Sex workers, like other people, should have human rights, all types of violence that they face should be eliminated and the social conditions they are exposed to should be improved. Sexually transmitted diseases, the most important health risk of sex workers, should be considered as occupational diseases in the new regulations.

Early and delayed pinhole MIBI SPECT in detecting hyperfunctioning parathyroid glands: a comparison with peroperative γ probe.

OBJECTIVE: This study was conducted to evaluate the early and delayed pinhole MIBI single photon emission computed tomography (pSPECT) images in detecting hyperfunctioning parathyroid glands, to make a comparison with peroperative γ probe (GP) findings. METHODS: Planar, early, and delayed pSPECT scans and skin in-vivo and ex-vivo GP counts were obtained in 22 patients with hyperparathyroidism. All data were analyzed statistically on the basis of localization of the lesions, using the histopathological findings as the gold standard. RESULTS: Histopathological examinations revealed 18 of 44 adenomas, 18 of 44 hyperplasic glands, two of 44 lymph nodules, five of 44 thyroid nodules, and one of 44 normal parathyroid glands. Sensitivity and specificity were found to be 36 and 100% for planar, 69 and 75% for early pSPECT, 86 and 88% for delayed pSPECT scans, and similarly, 78 and 75% on skin, 92 and 75% in-vivo and 83 and 100% ex-vivo GP counts, respectively. For distinction ability of GP counts between three groups of lesions, there was a statistically significant difference among the three groups for ex-vivo GP counts but not between groups of adenomas and hyperplasic lesions for in-vivo GP counts. CONCLUSION: Early and delayed pSPECT scans play a complementary role on the planar scans. Delayed pSPECT scans and in-vivo GP counts are equally valuable to localize both single and multiple hyperfunctioning parathyroid glands. Ex-vivo GP counts seem to be better for making a distinction among types of lesions.

The significance of the right hepatic artery originating from the superior mesenteric artery in patients with cavernous transformation of the portal vein.

PURPOSE: Dilatation of the hepatic artery in response to decrease in portal vein flow is known as hepatic arterial buffer response (HABR). In this study, the effect of HABR on variant hepatic arterial anatomy is investigated by analyzing the frequency of the right hepatic artery originating from the superior mesenteric artery (variant artery) and by determining the diameters of variant artery and common hepatic artery (CHA) in patients with cavernous transformation of the portal vein. MATERIALS AND METHODS: Forty-one patients who were referred for contrast-enhanced abdominal magnetic resonance angiography were retrospectively evaluated in two groups: group 1 (n = 15), cirrhotic patients with cavernous transformation of the portal vein; and group 2 (n = 26), cirrhotic patients without cavernous transformation of the portal vein. RESULTS: The frequency of the variant artery was significantly higher (53%) in patients with cavernous transformation of the portal vein (P < 0.01) than those without cavernous transformation (11.5%). The mean diameters of the CHA and the variant artery in 2 groups were not significantly different. CONCLUSION: Vasodilatation at the level of intrahepatic arterioles (HABR) in response to diminished portal flow may be a factor that increases the frequency of the variant hepatic artery.

Assessment of possible risk indicators for apical periodontitis in root-filled teeth in an adult Turkish population.

OBJECTIVE: The objective of this study was to determine possible independent risk indicators of apical periodontitis (AP) in root-filled teeth in an adult Turkish population. STUDY DESIGN: This study included subjects older than 15 years who had 1 or more root-filled teeth examined at the Baskent University Faculty of Dentistry. A total of 812 root-filled teeth were evaluated in 425 individuals. AP was the dependent variable and age, gender, length and density of root fillings, presence of periodontal problems, posts, localization of tooth, and tooth type were identified as independent variables. Generalized Estimating Equation (GEE) models were used in statistical analysis. RESULTS: AP was detected on 148 teeth (18.2%) in 812 root-filled teeth. According to multiple GEE model, males were more likely to have AP than females. Of the dental variables, length of root fillings, periodontal problems and tooth type were significantly associated with AP. CONCLUSIONS: The present study indicates that to be male and dental variables including length of root fillings, periodontal problems, and molar teeth were significantly associated with AP.

Comparative study on auscultatory and oscillometric methods of ambulatory blood pressure measurements in adult patients.

BACKGROUND: Ambulatory blood pressure (BP) monitors measure BP by oscillometric (Osc) or auscultatory (Aus) methods. In this study, we aimed to compare the values obtained by BP measurement methods in the ambulatory blood pressure monitoring (ABPM) device that can take measurements using both the methods, factors influencing these values, and their relevancy in obtaining valid measurement percentages. METHODS: The study was conducted on 212 patients. BP values of these patients were measured with the Nissei DS-250 (Nihon Seimitsu Sokki Co. Ltd, Gunma, Japan) monitor capable of recording BP simultaneously by the Aus and the Osc methods. The cases, for which no records were obtained by any one of the two methods, were considered to have missing records. The impacts of age, sex, body mass index, and arm circumference on the valid BP measurement values were examined. RESULTS: The valid measurement percentage without any missing records obtained by the Osc method was 87.3 and 16% by the Aus method. The body mass index, age, and arm circumference did not affect this percentage. The 24-h BP measurement values were higher by the Osc method. The differences between both methods in systolic blood pressure and diastolic blood pressure were 3.8+/-4.6 and 2.3+/-2.7 mmHg, respectively. Although the Aus method yielded higher standard deviation values than the Osc method for systolic blood pressure, standard deviation values obtained by the Osc method were higher than those obtained by the Aus method for diastolic blood pressure. CONCLUSION: The percentage of obtaining valid measurements by the Osc method used in the Nissei DS-250 model ABPM device examined in this study is higher when compared with the Aus method. Therefore, while examining ABPM results, the Osc method may be preferable over the Aus method.

Glu298Asp polymorphism of the eNOS gene is associated with coronary collateral development.

OBJECTIVE: We examined the endothelial nitric oxide (eNOS) gene Glu298Asp polymorphism to assess its possible association with the extent of coronary collaterals. METHODS: A total of 473 consecutive patients who had high grade coronary stenosis or occlusion were evaluated for the extent of coronary collaterals by using Rentrop classification. Patients with grade 0 or 1 collaterals were identified as having poor collaterals. The relation between collateral status and eNOS Glu298Asp polymorphism was studied by multivariate logistic regression analysis. RESULTS: Subjects with poor collaterals were more likely to have diabetes mellitus (p<0.001) and unstable angina pectoris as clinical presentation (p=0.014) and more likely to carry Asp298 variant (p=0.02) but they were less likely to have received statins (p=0.031). Multivariate analysis demonstrated that Asp298 allele carriers were 1.7 times more likely to have poor collaterals than patients with GluGlu genotype (95% CI: 1.09-2.69, p=0.024). There was a significant interaction between diabetes mellitus and eNOS Glu298Asp polymorphism in the analysis of collateral development. Among 145 diabetic patients Asp298 allele was the only predictor of poor collateral development with OR of 5.38 (95% CI: 2.41-11.98, p<0.001). Once diabetic patients were excluded from the analysis Asp298 allele was no longer a significant correlate of poor collateral formation. CONCLUSIONS: The present study suggests that the Asp298 allele of the eNOS gene is significantly associated with impaired collateral development, especially in patients with diabetes mellitus. Treatment strategies that modulate eNOS activity and/or NO production may improve coronary collateral development.

Evaluation of shoulder balance in the normal adolescent population and its correlation with radiological parameters.

A descriptive clinical study in healthy adolescents was done to evaluate the clinical shoulder balance and analyze the correlation between clinical and radiological parameters which are currently used to evaluate shoulder balance. In addition to trunk shift and rib hump, shoulder balance is one of the criteria that are used to evaluate the outcomes in spinal deformity surgery. Several methods have been proposed to evaluate the shoulder balance in scoliotic patients; however, there is no uniformity to these methods in the current literature. Patients who applied to pediatric clinic without musculoskeletal pathology formed the patient population. Volunteers were asked to fill out a questionnaire assessing shoulder balance perception and had their clinical photograph taken simultaneously with a P-A chest X-ray. The clinical shoulder balance was evaluated through analysis of the clinical photograph. The X-rays were used to evaluate the radiological shoulder balance. The evaluated parameters included coracoid height difference (CHD), clavicular angle (CA), the clavicle-rib cage intersection difference (CRID), clavicular tilt angle difference (CTAD), and T1-tilt. The study group was composed of 48 male and 43 female patients with an average age of 13.6 +/- 2.1 (10-18) years. In the questionnaire, all patients stated that their shoulders were level. The digital photographs revealed that only 17(18.7%) adolescents had absolutely level shoulders. The average height difference between shoulders was 7.5 +/- 5.8 mm. The average CHD was 6.9 +/- 5.8 mm, average CA was 2.2 +/- 1.7 degrees , average CRID was 4.8 +/- 3.6 mm, average CTAD was 4 +/- 3.2 degrees , and average T1-tilt was 1.3 +/- 1.4 degrees . CHD, CA, and CRID demonstrated high correlation with clinical pictures, whereas CTAD demonstrated moderate and T1-tilt demonstrated only mild correlation. The radiological parameters used to evaluate the shoulder balance correlate with the clinical appearance. Contrary to popular belief, shoulder balance in healthy adolescents often does not exist.

Is thyroglobulin the stronger indicator for progressive disease than the other conventional factors in same age patient groups with differentiated thyroid cancer?

AIM: To determine the thyroglobulin cut-off value as an indicator for progressive disease and to research relationships between sex, histological type, extra-capsular invasion and progressive disease in differentiated thyroid cancer. METHODS: Four hundred and eight patients were evaluated retrospectively. One hundred and fifty-eight patients (group 1) treated for progressive disease and 166 patients (group 2) that were ablated for thyroid remnant were included in our study. Sex, age, histological type, presence of extra-capsular invasion at the diagnosis and L-thyroxine off thyroglobulin values (6-12 months after the ablation) were obtained. Data were analysed by statistical methods. RESULTS: There was no statistically significant difference for ages (group 1, 45.3+/-16.1 years; group 2, 47+/-12 years, P>0.05). The chi-squared test revealed statistically significant differences for histological type (P>0.05) and extra-capsular invasion (P<0.001) but not for sex (P>0.05). Feasible cut-off level, sensitivity and specificity were found as a 10 ng.ml thyroglobulin value, 79% and 97%, respectively. However, sensitivity and specificity were 80%, 92% for 5 ng.ml and 82% for 2 ng.ml thyroglobulin levels. Multivariate analysis showed that a 10 ng.ml thyroglobulin cut-off value and extra-capsular invasion were independent prognostic factors. CONCLUSION: Increased thyroglobulin level, extra-capsular invasion and follicular type were poor prognostic factors but sex was not, whereas only extra-capsular invasion and increased thyroglobulin level were independent prognostic indicators for our groups. A 10 ng.ml thyroglobulin level was a feasible cut-off and seemed to be a stronger factor than other indicators to predict progressive disease.

Opposed phase imaging in lumbar disc disease: an option providing faster image acquisition times.

PURPOSE: To investigate the utility of opposed phase imaging (OPI) (in-phase and out-of-phase) in lumbar disc disease. MATERIALS AND METHODS: A total of 127 patients suspected of disc disease were examined with both traditional lumbar spine protocol (fast spin-echo [FSE] T1-weighted, T2-weighted sagittal, and T2-weighted axial) and OPI. Images were evaluated to detect the disc disease and to assess the anatomical clarity of certain spinal structures by two different radiologists using a four-point scale (1 = inadequate, 2 = adequate, 3 = good, and 4 = optimal). Results of two methods in terms of pathologic conditions and anatomical structures were compared. Comparison of the methods and the interpretations of two radiologists were performed by using kappa statistics. The difference among two methods in terms of anatomic clarity was assessed by using Wilcoxon analysis. RESULTS: Disc disease detected by each technique demonstrated concurrence (agreement was 82.4% and 93.1% for two radiologists; P < 0.05). OPI received similar scores with conventional sequences for disc disease (P > 0.05). OPI was optimal in displaying disc, marrow, osteophytes, and hemangiomas, where other structures got higher scores on conventional images (P > 0.05 and P > 0.001). But these structures had equal scores at least in one of the opposed-phase images. Acquisition time for OPI and conventional images were 4.46 and 9.01 minutes, respectively. CONCLUSION: OPI can be a faster backup technique in evaluating the lumbar disc disease. It has a shorter image acquisition time with adequate diagnostic quality. It can be a "time saver" option for busy MR centers or may be used for patients who cannot tolerate longer acquisition times.

Radiographic measurement of the sagittal plane deformity in patients with osteoporotic spinal fractures evaluation of intrinsic error.

Cobb method has been shown to be the most reliable technique with a reasonable measurement error to determine the kyphosis in fresh fractures of young patients. However, measurement errors may be higher for elderly patients as it may be difficult to determine the landmarks due to osteopenia and the degenerative changes. The aim of this study is to investigate the intrinsic error for different techniques used in evaluation of local sagittal plane deformity caused by OVCF. Lateral X-rays of OVCF patients were randomly selected. Patient group was composed of 28 females and 7 males and the mean age was 62.7 (55-75) years. The kyphosis angle and the vertebral body height were analyzed to reveal the severity of sagittal plane deformity. Kyphotic deformity was measured by using four different techniques; and the vertebral body heights (VBH) were measured at three different points. The mean intra-observer agreement interval for kyphosis angle measurement techniques ranged from +/-7.1 to +/-9.3 degrees while it ranged from +/-4.5 to +/-6.5 mm for VBH measurement techniques. The mean interobserver agreement interval for kyphosis angle ranged from +/-8.2 to +/-11.1 degrees , while it was between +/-4.5 to +/-6.5 mm for vertebral body height measurement techniques. This study revealed that although the intra and interobserver agreement were similar for all techniques, they are still higher than expected. These high intervals for measurement errors should be taken into account when interpreting the results of correction in local sagittal plane deformities of OVCF patients after surgical procedures such as vertebral augmentation techniques.

Antinucleosome antibodies and systemic lupus erythematosus.

The aim of this study is to investigate the prevalence of antinucleosome antibody in systemic lupus erythematosus (SLE) and their association with disease activity and renal involvement. The study included 131 patients with SLE, 74 rheumatoid arthritis, 26 systemic sclerosis, and 50 healthy individuals. Antinucleosome antibody and anti-dsDNA antibody were measured by an enzyme-linked immunosorbent assay (ELISA). Antinuclear antibody was tested by immunofluorescence using HEp-2 cells. Out of 131 SLE patients, 72 (54.9%) were seropositive for antinucleosome antibody, which was significantly higher than only 3 of 74 (4%) patients with rheumatoid arthritis (chi(2) = 52.82, P < 0.001); none of the patients with systemic sclerosis and 50 healthy individuals were seropositive. The sensitivity and specificity of antinucleosome antibodies in SLE were 83.6% and 70%, respectively. Fifty-one (38.9%) of SLE patients had renal involvement. Among these patients, the rate of antinucleosome positivity and anti-dsDNA were 74.5% and 78.4%, respectively. Antinucleosome antibodies were found to be 31.4% positive in SLE patients lacking anti-dsDNA antibody. Antinucleosome antibodies significantly correlated with disease activity (r = 0.428, P < 0.001) and anti-dsDNA (r = 0518, P < 0.001). The positivity of antinucleosome antibodies was significantly higher in patients with renal disease than the subjects without renal disease (chi(2) = 12.89, P < 0.001). The results of our study have revealed that in SLE patients, antinucleosome antibody could be a useful parameter for the assessment of disease activity or renal involvement.

Intrabiliary rupture of hepatic hydatid cysts: diagnostic accuracy of MR cholangiopancreatography.

OBJECTIVE: The purpose of this study was to establish the role of MR cholangiopancreatography (MRCP) in the diagnosis of biliary rupture in hepatic hydatid disease. We sought to determine whether the morphologic features of cysts and bile duct abnormalities detected on MRCP are specific enough for identification of intrabiliary rupture. CONCLUSION: If one of the following MRCP findings of apparent connection between hydatid cyst and biliary system, deformation of cyst, focal defect in cyst wall, or beaklike projection extending from cyst wall was present in a patient with hepatic hydatid cyst, the sensitivity of MRCP was 91.7% and the specificity was 82.8% for identification of intrabiliary rupture.

Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire.

STUDY DESIGN: Validation study to define validity and reliability of an adapted and translated questionnaire. OBJECTIVE: Assessment of the concurrent validity and reliability of a Chinese version of SRS-22 outcome instrument. SUMMARY OF BACKGROUND DATA: No valid health-related quality of life (HRQL) outcome instrument exists for patients with spinal deformity in Chinese. The modified SRS-22 questionnaire was proven to be an appropriate outcome instrument in English, and has already been translated and validated in several other languages. METHODS: The English version of the SRS-22 questionnaire was adapted to Chinese according to the International Quality of Life Assessment Project guidelines. To assess reliability, 48 subjects with adolescent idiopathic scoliosis (mean age, 16.5 years) filled the questionnaire on 2 separate occasions (Group 1). To assess concurrent validity, 50 subjects (mean age, 21 years) filled in the same questionnaire and a previously validated Chinese version of the Short Form-36 (SF36) questionnaire (Group 2). Internal consistency, reproducibility and concurrent validity were determined with Cronbach's alpha coefficient, interclass correlation coefficient and Pearson correlation coefficient, respectively. RESULTS: Cronbach's alpha coefficient for the 4 major domains (function/activity, pain, self-image/appearance and mental health) were high. Intraclass correlation was also excellent for all domains. For concurrent validity, excellent correlation was found in 1 domain, good in 12 domains, moderate in 3 domains, and poor in 1 domain of the 17 relevant domains. DISCUSSION: Both cultural adaptation and linguistic translation are essential in any attempt to use a HRQL questionnaire across cultures. The Chinese version of the SRS-22 outcome instrument has satisfactory internal consistency and excellent reproducibility. It is ready for use in clinical studies on idiopathic scoliosis in Chinese-speaking societies.

A comparative study of an ambulatory blood pressure measuring device and a wrist blood pressure monitor with a position sensor versus a mercury sphygmomanometer.

BACKGROUND: Self-measurements of blood pressure (BP) and 24-hour BP measurements are better predictors of cardiovascular mortality and morbidity than office BP measurements. The objective of this study was to compare the accuracy and precision of a wrist BP monitor with a position sensor (Omron 637IT) and of an ambulatory BP measuring monitor (ABPM; Nissei DS-250) with a mercury sphygmomanometer. METHODS: A total of 139 patients (69 women and 70 men) were included in the study. The BP of each subject was first measured with a mercury device using the same (left) arm. After this, the wrist monitor was used for BP measurement. Upon completion of the BP readings, 24-hour BP monitoring was performed using Nissei DS-250 monitors. Mean and standard deviations were calculated for all devices. In order to assess the agreement between the measurement methods, the Bland-Altman method and graphics were utilized. RESULTS: The mean systolic BP measured by the mercury device was 133.2+/-18.4 mmHg and the diastolic BP was 85.4+/-12.5 mmHg, whereas the digital device measured systolic BP as 135.7+/-17.2 mmHg and diastolic BP as 87.0+/-12.5 mmHg. The 24-hour BP measurement was 134.6+/-16.6 mmHg for systolic BP and 85.6+/-11.1 mmHg for diastolic BP. The difference with regard to systolic BP between the mercury and the Omron devices was -2.5+/-5.3 mmHg, which is within the AAMI standard. However, while the mean values of the differences between the mercury and ABPM devices remained under 5 mmHg, their standard deviation was above +/- 8 mmHg. For diastolic BP, the difference between all of the devices was below 5+/-8 mmHg. CONCLUSIONS: The wrist BP monitor produced results consistent with those of the mercury sphygmomanometer when both were compared with the results of the ABPM. As BP measurement with these devices is a practical and repeatable method, they can be used instead of ABPM in the diagnosis and monitoring of hypertension. However, there is a need for further comparative studies.