The safety and efficacy of TNF inhibitors in patients with Behçet's disease: Retrospective study from eastern Turkey.

OBJECTIVE: We aimed to evaluate the clinical features, disease course, and associated factors for outcome in severe/refractory BD patients receiving TNF-i treatment. MATERIAL AND METHODS: This retrospective study was conducted by reviewing medical records from a tertiary referral center in Van province in Eastern Turkey. Data were obtained from patients' charts followed up between June 2019 and June 2022. RESULTS: We included 469 BD patients (59.3% male) whose 80 patients (17%) received TNF-i treatment in the study. The mean ± standard deviation of the patient age was 36.7 ± 10.1 years and the median (IQR) disease duration was 12 (12) years. IFX and ADAwere initiated in 67.5% (n = 54) and 32.5% (n = 26) patients, respectively. Overall and first-line retention rates of TNF-i were 84.7% and 92.6% for IFX and 83.3% and 80.8% for ADA, respectively. IFX was discontinued in 9 patients which were in 2 patients due to allergic reaction and tuberculosis, 3 patients for inefficacy, one patient for heart failure, and one patient for orbital zona. Although no serious adverse event was observed with ADA, 5 patients switched to IFX due to inefficacy. Overall, 72 patients (90%) resumed TNF-i at the end of the study; TNF-i was discontinued in 3 patients (3.8%) due to severe adverse events and in 5 patients (6.2%) with prolonged remission. CONCLUSION: In our study, no case of death was observed in TNF-i receiving patients. Most patients achieved attack-free and CS-free disease and retained TNF-i treatment. TNF inhibitors appear to be safe and effective in patients with severe/refractory Behçet's disease.

The Turkish version of nursing practice readiness scale: Cross-cultural adaptation and psychometric evaluation.

AIM: This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties. BACKGROUND: New graduates' nursing practice readiness can impact their work adaptation and performance. DESIGN: The research employed a methodological design. METHODS: Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item-total correlation, Cronbach's a coefficient, composite-reliability and split-half reliability. RESULTS: The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five-factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split-half reliability, the correlation coefficient between half was 0.952, with a Spearman-Brown Coefficient (Unequal Length) of 0.976. CONCLUSIONS: The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses.

The effect of middle and high school students' emotional eating behavior on obesity.

AIM: This study was conducted to determine the effect of middle and high school students' emotional eating behavior on obesity. METHOD: A descriptive, correlational, and cross-sectional study design was used. The sample consisted of 267 students studying in 5th, 6th, 7th, 8th, 9th, 10th, 11th, and 12th grades. Data were collected using a Child Information Form and the Emotional Eating Scale. The researchers measured the students' height and weight and calculated their body mass indices (BMI), and BMI percentiles were evaluated according to age and gender. Percentage calculations, mean scores, Spearman correlation analysis, Pearson's correlation analysis, and multiple regression analysis were used in the analysis of the data. RESULTS: Of the students participating in the study, 54.7% were girl and 45.3% were boy. It was determined that 28.4% of the students were overweight and obese. As a result of multiple regression analysis, it was determined that students' emotional eating behavior explained 25% of obesity (p < 0.001). It was found that anxiety-anger- frustration, one of the subscales of the emotional eating scale, was the only variable that significantly predicted students' obesity status (ß = 0.387). Emotional eating significantly predicted the obesity status of boy and girl students (p < 0.001). CONCLUSION: In this study, it was concluded that students' emotional eating behavior affected obesity. IMPLICATIONS FOR PRACTICE: In line with these results, it is recommended that studies on other variables that may predict the effect of students' emotional eating behavior on obesity should be conducted and that nurses should contact schools to conduct emotional eating behavior screenings and provide emotional eating education for students who exhibit emotional eating behavior.

Individualized High Dose Intravenous Anakinra Treatment in Cancer Patients with COVID-19 Associated Cytokine Storm: A Retrospective Controlled Study.

Objective: Patients with COVID-19 accompanying cancer have been reported to have higher morbidity and mortality. In this study, we aimed to evaluate the high-dose high intravenous anakinra treatment response and outcome in patients with COVID-19-associated cytokine storm accompanying cancer. Materials and Methods: This retrospective observational study was carried out at a tertiary referral center between September 01, 2021, and February 01, 2022, in Turkey. The study population consisted of two groups: patients receiving high-dose intravenous anakinra and patients treated with standard care. Results: Data from 146 patients in the anakinra group and 114 patients in the control group were analyzed. Malignancy frequency was 11% (n=16) in the anakinra group and 7% (n=8) in the control group. In survival analysis, a significantly lower survival rate was observed in patients with malignancy than those without in the control group (log-rank: p=0.002) and patients with malignancy in the control group compared to the anakinra group (log-rank: p=0.013). However, it did not differ between patients with and without malignancy in the anakinra group (log-rank: p=0.9). Conclusion: In the control group, mortality was higher in patients with malignancy compared to those without malignancy, but not in the anakinra group. Also, mortality was higher in patients receiving SoC compared to anakinra. Intravenous high-dose anakinra treatment is safe and effective in patients with COVID-19 accompanying cancer.

Development and psychometric analysis of a pediatric cancer survivors Psychosocial Late Effects Scale (PCSLES).

PURPOSE: Although the physiological late effects of childhood cancer survivors are more obvious, appropriate assessment of psychosocial effects is needed. Therefore, it was aimed to develop a scale to evaluate psychosocial late effects in cancer survivors and to test its validity and reliability. DESIGN AND METHODS: This methodological study was conducted with 100 children and adolescents who survived were collected at the oncology center in the south of Türkiye in 2022. Data were collected with the "Personal Information Form" and "Pediatric Cancer Survivors Psychosocial Late Effects Scale (PCSLES)" IBM SPSS 24.0 and IBM AMOS 24.0 software programs were used for data analysis, and descriptive statistics were used to analyze numeric variables. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. RESULTS: The factorial analysis was used to test the structural validity of the scale. A four-factor structure consisting of 17 items was developed. The Cronbach's alpha coefficient for "1" was 0.89, "2" was 0.87, "3" was 0.80, "4" was 0.82 and the total score was 0.92. Fit indices resulting from the study were χ2/SD: 1.497, root mean square error of approximation (RMSEA): 0.071, goodnessof-fit index (GFI): 0.85, comparative-of-fit index (CFI): 0.94, and normed fit index (NFI): 0.85. CONCLUSION: The scale is a valid and reliable scale that can be used to determine psychosocial late effects in pediatric cancer patients. PRACTICE IMPLICATIONS: Utilizing the PCSLES can assist in identifying the psychosocial symptoms of child survivors/adolescents and facilitate the planning of appropriate interventions.

Combination therapy of high-dose intravenous anakinra and baricitinib in patients with critical COVID-19: Promising results from retrospective observational study.

INTRODUCTION: In this study, we aimed to evaluate the safety and efficacy of combination treatment of high-dose intravenous anakinra and baricitinib in patients with critically ill COVID-19. MATERIAL AND METHODS: This retrospective observational study was conducted in a tertiary center with diagnosis of COVID-19 patients.Study population consisted of patients with positive polymerase chain reaction and computer tomography findings compatible with COVID-19 as well as critical illness. RESULTS: Data of 15 patients in combination group and 43 patients in control group were evaluated and included into the study. Overall mortality was 46.7 % (n = 7) in combination arm and 69.8 % (n = 30) in control group although it was not statistically significant (p = 0.1). Similarly, need of intubation was also lower in combination arm (46.7 %) compared to control group (69.8 %), it was not significantly different (p = 0.1). ICU admission was significantly lower in combination (46.7 %, n = 7) arm than control group (76.7 %, n = 33) (p = 0.03, Odds ratio [OR]:4.7). Development of severe infection (20 %, n = 3 vs 25 %, n = 9/36), pulmonary embolism (6.7 %, n = 1 vs 0), myocardial infarction (6.7 %, n = 1 vs 2.6 %, n = 1/38) and pneumothorax (13.3 %, n = 2 vs 2.6 %, n = 1/38) were not different between two groups (p = 0.7, p = 0.3, p = 0.5 and p = 0.2). In multivariable analysis only cHIS score was associated with high mortality (p = 0.018, OR:2.8, [95 % confidence interval: 1.2-6.6]). In survival analysis, mortality rate was significantly lower in combination arm than control group (Log-Rank:p = 0.04). CONCLUSION: Combination therapy of high-dose anakinra and baricitinib may be an adequate treatment option in patients with COVID-19 who had critical disease and has acceptable safety profile.

Utility of positron emission tomography as a new tool for muscle involvement in patients with idiopathic inflammatory myositis: a controlled study.

OBJECTIVES: Idiopathic inflammatory myositis (IIM) represents a rare group of disease that can affect multiple organs in addition to the muscles. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is an emerging scanning method that is widely used in diagnosing, staging and response to treatment in patients with cancer. In this study, we aimed to evaluate the muscle involvement in PET/CT which was performed for malignancy screening and its correlation with myositis-specific antibodies (MSA) and/or myositis-associated antibodies (MAA) in patients with IIM. METHODS: IIM patients who fulfilled 2017 EULAR/ACR classification criteria and had PET-CT scans during the active phase of myositis (within two weeks of starting steroids) were included into the study. Age and sex matched participants with history of malignancy (non-IIM patients) were defined as control group. RESULTS: Data of 160 IIM patients were evaluated and 34 patients (of 64.7% female) whose PET/CT results were available, included into the study. Fourteen patients with diagnosis of malignancy without IIM (non-IIM patients) defined as the control group. Sensitivity and specificity of a positive FDG muscle uptake were 37.1% and 100%, 65.7% and 92.9%, 91.4% and 7.1% compared to liver, mediastinum and LTM uptakes, respectively. In multivariate analysis, higher baseline CRP (p=0.017, confidence interval [CI] 95%: 1.03-1.36, OR:1.18) and LDH (p=0.029, CI 95%:1.001-1.017, OR:1.01) levels were associated with muscle PET/CT positivity. CONCLUSIONS: In patients with active IIM, median muscle FDG uptake with PET/CT was higher compared to non-IIM. PET/CT may be used for the evaluation of extent and activity in patients with IIM.

Development of Adolescents' perceptions of the nursing image scale and evaluation of its psychometric properties: A methodological study.

BACKGROUND AND PURPOSE: It is important to assess the perception of the nursing image among adolescents, the group closest to the career decision, to enhance their view of the nursing image. This study was conducted to develop the Adolescents' Perceptions of Nursing Image Scale (APNIS) and evaluate its psychometric properties. METHOD: The study has a descriptive, cross-sectional, correlational, and methodological design. The study was conducted with 614 adolescents aged 12-18 years in Turkey between October 15, 2022, and December 15, 2022. The data were analyzed using the Kaiser-Meyer-Olkin coefficient, Barlett's test, factor analyses, Cronbach's alpha reliability coefficient, split-half analysis, item sum statistics, Hotelling's T2, and test-retest analysis. RESULTS: As a result of the explanatory factor analysis, the items on the scale were collected under six sub-dimensions, and the scale explained 62.843% of the total variance. Confirmatory factor analysis showed that the model fit was adequate. The total internal consistency Cronbach alpha value of the scale is 0.90, and the sub-dimension Cronbach alpha values are between 0.70 and 0.90. The Spearman-Brown coefficient of the scale was 0.94, the Guttman-split-half coefficient was 0.94, Hotelling's T2 value was 373.829, F = 9.510, and p < 0.001. As a result of the Tukey summability analysis, F = 0.431 and p > 0.05, the scale was found to be summable. The test-retest result of the scale was r = 0.899. CONCLUSION: The 38-item APNIS is a valid and reliable tool that assesses adolescents' perceptions of the nursing image. PRACTICE IMPLICATIONS: The scale, including universal items about the nursing image, is easy and practical to use.

Psychometric Properties of the Spiritual Care Needs Scale for the 9-18 Age Group in Turkey.

This methodological study aimed to establish the validity and reliability of the Spiritual Care Needs Scale in the 9-18 age group within the Turkish context. Expert opinions were considered in the analysis of the study, which was completed with the participation of 840 children. The content validity index and Cronbach's alpha coefficients were examined, along with the results of the Shapiro-Wilk normality test and the explanatory and confirmatory factor analyses. The scale had 21 items under two subdimensions: "meaning and hope" and "caring and respect." According to the EFA, the scale explained 57.5% of the total variance. The meaning and hope subdimension explained 53.3% of the total variance, whereas the care and respect subdimension explained 4.16%. The total Cronbach's alpha value of the scale was 0.96, and the fit indexes were as follows: X2 = 513.807, df = 184, X2/df = 2.792, RMSEA = 0.065, GFI = 0.89, IFI = 0.94, NFI = 0.91, TLI = 0.93, CFI = 0.94, AGFI = 0.87, and GFI = 0.89. Therefore, the Spiritual Care Needs Scale is a valid and reliable measurement tool for the 9-18 age group in the Turkish population.

The Effect of Nursing Students' Liking of Children and Attitudes Toward Clinical Practice on Their Comfort and Worry Levels in the Pediatric Clinic.

This research was conducted as a descriptive and cross-sectional study to determine the effects of nursing students' liking of children and attitudes toward clinical practice on their comfort and worry levels in the pediatric clinic. The research was carried out with 270 nursing students who had already taken or were taking the child health and diseases nursing course. Data were collected using a Nursing Student Information Form, the Barnett Liking of Children Scale, the Nursing Students' Attitudes toward Clinical Practices Scale, and the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. Mean values, percentage calculations, and linear regression analysis were used for the analysis of the research data. Participants' mean scores were 52.30 ± 6.16 on the Barnett Liking of Children Scale, 103.72 ± 19.35 on the Nursing Students' Attitudes toward Clinical Practices Scale, 15.61 ± 3.74 on the comfort sub-dimension, and 11.63 ± 4.32 on the worry sub-dimension of the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. It was determined that the liking of children and attitudes toward clinical practice explained 43.6% of the clinical comfort level of pediatric nursing students in Model 1 and 45.2% of their clinical worry level in Model 2. It was determined that the liking of children and attitudes toward clinical practice significantly affected the comfort and worry levels of nursing students in the pediatric clinic.

Characteristics and course of patients with AA amyloidosis: single centre experience with 174 patients from Turkey.

OBJECTIVES: This study aimed to evaluate the clinical, laboratory and genetic characteristics and outcomes of patients with AA amyloidosis. METHODS: Patients followed up in a tertiary referral centre in Turkey with the diagnosis of inflammatory rheumatic diseases and immunohistologically proven AA amyloidosis were included in the study and retrospectively analysed. RESULTS: Among 184 patients with the diagnosis of AA amyloidosis, 174 (83 female, 91 male) were included in the analysis. The most common cause of AA amyloidosis was FMF (78.7%), and 91% of FMF-AA amyloidosis patients were carrying the p.M694V variant (74.1% homozygous). AA amyloidosis was identified earlier in patients with homozygous or compound heterozygous MEFV exon 10 variants compared with the heterozygous patients (27, 30 and 41 years, respectively). Patients with an estimated glomerular filtration rate <60 ml/min at admission had a higher frequency of progression to end-stage renal disease (P < 0.001). The overall mortality rate was 15.3% and it increased gradually in association with the amyloid burden (10% in patients with renal, 15% in renal + gastrointestinal and 43% in those with additional cardiac involvement). Renal findings responded completely to treatment in 31% of the patients, a partial response was observed in 4%, a stable course in 23.6% and progression in 38.5%. Amyloid storm was identified in nine patients and was found to be associated with increased mortality within 1 year. CONCLUSION: FMF patients still constitute the majority of AA amyloidosis patients in Turkey. The MEFV genotype and associated inflammatory load may affect the age of onset of AA amyloidosis, and earlier diagnosis and stricter follow-up and treatment may delay progression of the disease.

A rare case of hydatid cyst-associated AA amyloidosis and literature review of hydatid cyst-associated nephropathy.

Hydatid disease is an infective picture caused by echinococcus, which progresses with cysts in various organs, especially in the liver. Renal involvement is an unusual location in the course of the disease. Although mostly asymptomatic renal cysts are seen, rarely glomerular or tubular associated nephropathy develops. In addition, the development of amyloidosis has been shown previously in patients with untreated chronic hydatid cysts. We wanted to bring a 27-year-old female patient with a 10-year history of hydatid cyst and AA amyloidosis to the literature. In addition, in our literature review for hydatid disease-associated nephropathies, we brought together data from 12 studies involving a total of 21 cases. Of these cases, 3 were membranous glomerulonephritis (MGN), 5 were, membranoproliferative glomerulonephritis (MPGN), 1 was minimally change disease (MCD), 5 were AA amyloidosis (including our case), 3 were immunoglobulin A nephropathy (IgAN), 1 was tubulointerstitial nephritis (TIN), 1 was chronic kidney disease (CKD), 1 was TIN with mesangioproliferative glomerulonephritis (MesPGN), 1 was TIN with IgAN, 1 was MPGN with immunoglobulin M nephropathy (IgMN). In this way, we wanted to shed light on the relationship between Echinococcus and nephropathy. In this way, we wanted to emphasise the necessity of doing renal examinations in the follow-up of hydatid cyst patients.

Prenatal Attachment and Mental Well-Being Among Expectant Fathers Amidst COVID-19: A Cross-Sectional Study.

Background The COVID-19 pandemic has posed significant threats to global physical and mental health, notably impacting the psychological management of pregnancy. The mental health of parents plays a critical role in fostering the emotional bond with their unborn child, referred to as prenatal attachment. Despite the significance of this bond, research has primarily concentrated on maternal outcomes, often neglecting the paternal aspect during the pandemic. This study investigates the correlation between coronavirus disease 2019 (COVID-19) risk perception and paternal prenatal attachment, further exploring the mediating role of well-being within this association. Methods A total of 141 expectant fathers attending the gynecology and obstetrics outpatient clinic with their partners were recruited. Participants completed measures including the Paternal Antenatal Attachment Scale (PAAS), the World Health Organization Well-being Index (WHO-5), and the COVID-19 Perceived Risk Scale (CPRS). Results Data analysis revealed a significant negative correlation between COVID-19 risk perception and well-being (ß = -.34, p < .001). There was a positive correlation between well-being and prenatal attachment (ß = .37, p = .002). The prenatal attachment was also positively linked to COVID-19 risk perception (ß = .20, p = .047). Furthermore, well-being mediated the relationship between COVID-19 risk perception and prenatal attachment. Conclusion The findings underscore the potential of the COVID-19 risk perception to disrupt the prenatal attachment process for expectant fathers by interfering with psychological well-being. However, it can also promote prenatal attachment through various mechanisms. Consequently, acknowledging and understanding the experiences of fathers during pregnancy is of paramount importance. Future longitudinal studies are necessitated to examine the parent-child relationship dynamics that have evolved under the influence of the pandemic.

The effect of the closed intravenous catheter system on first insertion success, indwelling time, and complications in pediatric hematology and oncology patients: A randomized controlled study.

PURPOSE: The primary purpose of this research is to evaluate the effect of two different catheter systems (closed IV catheter system: BD Nexiva™, peripheral open IV catheter: BD Insyte™ Autoguard™) on first insertion success, catheter indwelling time, and the catheter complications. METHOD: This randomized controlled study used a single-blind and parallel trial design guided by the CONSORT checklist. The "Peripheral Intravenous Catheter (PIVC) Bundle" was applied to all patients. A total of 214 catheters of 38 patients were included in the intervention (BD Nexiva™) (n = 107 catheter) and control (open IV catheter) groups (n = 107 catheter) of the study. The indwelling time and PIVC complications were followed. RESULTS: The mean age of the patients in the study group was 5.9 ± 2.2, and the mean age of the patients in the control group was 5.7 ± 1.9. The PIVC was successfully placed in 68.2% of the patients in the study group and in 65.4% of the patients in the control group at the first attempt. It was determined that the indwelling time was 4.9 ± 3.9 (max. 20.25 days) in the study group and 2.9 ± 2.8 (max. 11.25 days) days in the control group. The complication rates were found to be 86.8 for the study group and 166.9 for the control group in 1000 catheter days. In this study, no difference was found in terms of complication. CONCLUSIONS: The PIVC indwelling time is longer in patients with the closed IV catheter system. These new technology PIVCs can be used for this special patient population. GOV IDENTIFIER: NCT05769452.

Media Parenting Scale for School-Aged Children (MEPA-20): Psychometric Properties of the Turkish Version.

BACKGROUND AND PURPOSE: Media parenting refers to the strategies and behaviors parents use to interact with their children regarding the amount, content, and context of screen use. Children's media/screen use is a significant indicator of media parenting practices. Therefore, this study aimed to determine the psychometric properties of the Turkish version of the Media Parenting Scale for School-Aged Children (MEPA-20). METHODS: This methodological study involved 524 parents with children aged 6-10 and was conducted between October 15, 2022, and February 15, 2023. In the data analysis, the Content Validity Index, Explanatory and Confirmatory Factor Analyses, Cronbach's alpha, Test-retest reliability, Hotelling T2 test, and item-total score correlation were used. The test-retest reliability analysis of the Turkish version of MEPA-20 was performed with 30 parents after 4 weeks. RESULTS: MEPA-20 consists of 20 items and three sub-dimensions (active, restrictive, and over-protective mediation). The MEPA-20 Turkish version and its three factors were found to indicate acceptable levels of internal consistency and reliability. The three-factor construct validity of the MEPA-20 Turkish version determined with Explanatory Factor Analyses was successfully confirmed with Confirmatory Factor Analysis. CONCLUSION: The MEPA-20 is a valid and reliable tool for assessing the media parenting practices of parents of children aged 6-10 years in the Turkish population. PRACTICE IMPLICATIONS: Based on the impact of media parenting practices on child and family health, nurses should raise awareness and support parents regarding children's healthy screen use.

Maternal prenatal attachment during the COVID-19 pandemic: exploring the roles of pregnancy-related anxiety, risk perception, and well-being.

Pregnant women have faced novel physical and mental health risks during the pandemic. This situation is remarkable because a parent's emotional bond with their unborn baby (also known as prenatal attachment) is related to the parent's mental state. Prenatal attachment helps parents psychologically prepare for the transition into parenthood. Moreover, it plays a pivotal role in the future parentchild relationship and psychosocial development of the baby. Based on the available literature, the current study integrated risk perception theories with mental health indicators to examine maternal prenatal attachment during the pandemic. Pregnant women (n = 258) completed the Pregnancy-Related Anxiety Questionnaire-Revision 2 (PRAQ-R2), the WHO Well-being Index (WHO-5), the Prenatal Attachment Inventory (PAI), and answered questions about COVID-19 risk perception. The findings illustrated that pregnancy-related anxiety was positively associated with maternal prenatal attachment. Moreover, COVID-19 risk perception and well-being mediated this relationship. In other words, the higher levels of pregnancy-related anxiety were associated with increased COVID-19 risk perception and decreased well-being, inhibiting prenatal attachment in pregnant women. Considering the importance of prenatal attachment, it is crucial to understand the experiences of pregnant women and develop policies for promoting prenatal attachment, especially during challenging times such as the COVID-19 pandemic.

The Predictive Power of Pain Characteristics and Sleep Quality on Fatigue in Adolescents With Cancer.

This study was conducted as descriptive, methodological, and cross-sectional research to determine the predictive power of pain characteristics and sleep quality on fatigue in adolescents with cancer. The study was conducted between November 2020 and April 2021 with 139 adolescents with cancer who reported pain. The study data were collected via an AdolescentInformation Form, the Adolescent Pediatric Pain Tool, the Scale For The Assessment Of Fatigue in Pediatric Oncology Patients Aged 13-18, and the Sleep Assessment Scale for Children with Cancer-Adolescent Form. Mean values, percentage calculations, Pearson correlation analysis, and linear regression analysis were used in the analysis of the data. There was a high level and negative correlation between pain characteristics (pain location, severity, and quality) of the adolescents participating in the study and their mean scores from the overall fatigue scale and its subdimensions and a high level and positive correlation with their mean scores from the overall sleep quality scale. Pain characteristics and sleep quality of adolescents with cancer explained 74% of fatigue. Pain, sleep quality, and fatigue are symptoms that should be closely addressed in adolescents with cancer.

The relationship between the severity of inflammatory bowel diseases and expirium air carbon monoxide levels.

INTRODUCTION: We investigated the relationship between expirium air carbon monoxide (E-CO) levels and disease severity in patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS: After their first follow-ups, the E-CO levels of 162 patients with UC and 100 with CD were measured for four consecutive weeks. Blood samples were collected from all the patients, and their clinical severity was determined 1 month after their initial presentation. The clinical severity of CD was determined using the Harvey Bradshaw index (HBI), while the patients with UC completed the SEO clinical activity index (SEOI). The relationships between the disease severity and the means of these four E-CO readings were then compared. RESULTS: The mean age of the participants was 42.28 ± 14.9 years, and 158 (60.3%) were men. In addition, 27.2% of the UC group and 44% of the CD group were smokers. The mean SEOI score was 145.7 ± 42.0 (min = 90, max = 227), and the mean HBI score was 5.75 ± 3.3 (min = 1, max = 15). Increased CO ppm (OR = -9.047 to 7.654 95% CI) and the number of cigarettes smoked per day (OR = -0.161 to 1.157 95% CI) emerged as independent risk factors for lower SEO scores in the linear regression models (p < 0.001), while the number of cigarettes smoked per day (OR = 0.271 to 1.182% 95 CI) was a risk factor for higher HBI scores (p = 0.022). CONCLUSION: UC severity decreased with higher E-CO levels and the mean number of cigarettes smoked, while CD severity increased in line with the mean number of cigarettes smoked.

Characteristics of Patients With Behçet Disease From the Van Province, Eastern Turkey: Definition of Disease Clusters in a Tertiary Referral Center.

BACKGROUND: Behçet disease (BD) is a chronic inflammatory systemic disease that affects skin mucosa, joints, eyes, and blood vessels. Behçet disease shows some clinical differences in terms of disease manifestations and prognosis among the Silk Road countries, as well as various ethnicities even in the same country. In this study, we aimed to evaluate the clinical features and disease course of BD using cluster analysis in Van province, Eastern Turkey. METHODS: This study was carried out in a tertiary referral center in Van province, by reviewing medical records. Seven disease manifestations were included to the cluster analysis as follows: mucocutaneous findings (oral ulcer, genital ulcer, erythema nodosum-like lesions, pseudofolliculitis), uveitis, superficial thrombophlebitis, musculoskeletal involvement, gastrointestinal system involvement, vascular involvement, and parenchymal central nervous system involvement. RESULTS: We identified 467 patients. After the exclusion of 6 patients who had missing data and 17 patients who did not live in Van, 444 patients (59.2% male) included into the study. Meeting the International Study Group and the International Criteria for Behçet Disease criteria were 91.6% and 96%, respectively, and 91.3% (n = 379/415) of these patients met both criteria. Four clusters were identified in the analyses: 132 patients (31.2%) in vascular (C1), 66 patients (15.6%) in ocular (C2), 60 patients (14.2%) in musculoskeletal (C3), and 165 patients (39%) in mucocutaneous (C4) clusters. Male gender ( p = 0.002; odds ratio [OR], 6.5; 95% confidence interval [CI], 2-21.4), superficial thrombophlebitis ( p = 0.001; OR, 4.7; 95% CI, 1.9-11.4), and uveitis ( p = 0.01; OR, 3.6; 95% CI, 1.3-9.9) were associated with vascular involvement in multivariate analysis. CONCLUSIONS: In our study, 4 clusters were detected in patients with BD from Van province. The prevalence of severe manifestations of BD may be related to genetic or environmental factors, such as differences in ethnicity and/or geographical differences. Despite the higher proportion of patients with a more severe disease, a favorable outcome was observed in our cohort.

Psychometric properties of the Turkish version of the vital signs monitoring on pediatric wards scale (Ped-V scale).

PURPOSE: The aim of this study should be to adopt the Turkish version of the vital signs monitoring on pediatric wards scale (Ped-V scale). DESIGN AND METHOD: This methodological study was carried out with 331 pediatric nurses aged 18-65 between September 2022 and November 2022. The data were collected using an online questionnaire including a Descriptive Information Form and the Ped-V scale. Before starting the implementation of the study, the language adaptation of the scale was made, then expert opinion was taken and a pilot application was made. Then the main sampling was applied and evaluated. Explanatory and confirmatory factor analysis, Cronbach's alpha, and item-total score analysis were used for data analysis. RESULTS: It was determined that the scale consisted of 30 items and four sub-dimensions and that four sub-dimensions explained 42.91% of the total variance. Both exploratory and confirmatory factor analyses indicated that all factor loads were >0.30. According to the confirmatory factor analysis, all of the fit indices were >0.80, and the RMSEA was <0.080. Cronbach's alpha was determined as 0.88 for the total scale and >0.60 for all sub-dimensions. CONCLUSION: As a result of the analyses, it was determined that the Ped-V scale was a valid and reliable measurement tool for the Turkish sample. PRACTICE IMPLICATIONS: Using the Ped-V scale, it can help to determine the attitudes of nurses working in pediatric clinics toward monitoring vital signs and to plan in-service training if there is a problem.