The effects of women's insight levels on breast cancer prevention behaviors: a cross-sectional study

The aim of this study is to determine the effect of women's insight levels on their breast cancer prevention behaviors in primary health care services. A systematic sampling method was used to select a sample of 393 women in a province in Turkey. Socio-demographic Characteristics Form, Insight Scale and Scale for Determining Factors Affecting Women's Breast Cancer Prevention Behaviour were used as data collection tools. Data were collected face-to-face and then analyzed statistically using Student's t-test, one-way analysis of variance, Tukey HSD, Spearman correlation test and multiple regression analysis. The results showed that those who felt "healthy" had significantly higher mean breast cancer prevention behavior (p < .05). It was determined that there was a weak positive correlation between the level of insight and breast cancer prevention behaviors, and the increase in the level of insight had a significant positive effect of 0.37 ± 0.051 points on breast cancer prevention behaviors. It was found that there was a significant negative effect on prevention behaviors with 1.66 ± 0.796 points in those with a high education level and 1.58 ± 0.505 points in those with suspected disease. In conclusion, in this study, it was determined that insight level, education level, and awareness of early diagnosis affected the prevention behaviors of breast cancer.

Sexual quality of life and marital adjustment in pregnant women

In a cross-sectional study, researchers investigated pregnant women's quality of sexual life and marital adjustment. The sample consisted of 312 pregnant women admitted to the gynecology and obstetrics outpatient clinic of State Hospital between June and November 2020. Data were collected using a personal information form, the Quality Scale-Female (SQLQ-F), and Marriage Adjustment Test (MAT). Participants with one child had a significantly higher median SQLQ-F score than those with three or more children. Participants with 8-12 wk of pregnancy had a significantly higher median SQLQ-F score than those with 25 wk of pregnancy or longer (p < 0.05). There was a positive correlation between SQLQ-F and MAT scores (r = 0.447. p < 0.001), suggesting that the higher the quality of sexual life, the better the marital adjustment. Health care professionals should be aware of the effect of sexual life on marital adjustment.

Chylothorax due to thrombosis of the jugular and subclavian veins in a patient with gastric cancer: a case report

BACKGROUND

Chylothorax is a rare condition due to leakage of chyle in the thoracic cavity. When large amounts of chyle leak into the thoracic cavity, it can lead to severe respiratory, immune, and metabolic complications. Chylothorax has many potential underlying etiologies, and the most common causes are traumatic chylothorax and lymphoma. Venous thrombosis of the upper extremities is a rare cause of a chylothorax.

CASE PRESENTATION

A 62-year-old Dutch man with a medical history of gastric cancer, treated with neoadjuvant chemotherapy and surgery 13 months prior, presented with dyspnea and a swollen left arm. Computed tomography thorax showed bilateral pleural effusion that was more prominent on the left side. The computed tomography scan further revealed thrombosis of the left jugular and subclavian veins and osseal masses suggesting cancer metastasis. Thoracentesis was performed to confirm the suspicion of gastric cancer metastasis. The obtained fluid was milky with a high level of triglycerides, but contained no malignant cells; hence, the diagnosis of the pleural effusion was chylothorax. Treatment with anticoagulation and a medium-chain-triglycerides diet was started. Furthermore, bone metastasis was confirmed with a bone biopsy.

CONCLUSION

Our case report demonstrates chylothorax as a rare cause of dyspnea in a patient with pleural effusion and a history of cancer. Therefore, this diagnosis should be considered in all patients with a history of cancer with new-onset pleural effusion and thrombosis of the upper extremities or clavicular/mediastinal lymphadenopathy.

The relationship between beliefs toward mental illnesses, empathic tendency and social distancing in university students

This study was conducted to determine the level of beliefs toward mental illnesses in university students and to examine its relationship with empathic tendency and social distance level. This descriptive and relational study was conducted at the Faculty of Health Sciences and Faculty of Nursing of a state university in Turkey. The sample of the study consisted of 678 students studying in the 4th grade of these faculties. Personal Information Form, the Beliefs Toward Mental Illness Scale (BMI), the Empathic Tendency Scale (ETS), and the Social Distance Scale (SDI) were used to collect data. It was determined that there was a high level of negative relationship between the students' mean BMI score and the age variable and the empathic tendency and social distance mean scores. It was seen that the mean Empathic Tendecy Scale and Social Distance Scale scores accounted for 86.6 % of the change in the mean BMI score (Adjusted R2 = 0.826). The mean BMI score of the students was found to be below the medium level. On the other hand, it was found that empathic tendency and social distance mean scores were above the medium level and had an effect on the mean BMI score. Psychosocial factors that are effective in the emergence of negative beliefs about mental illnesses in students should be investigated and studies should be carried out to increase awareness about negative beliefs.

AB1498 THE BIOPSYCHOSOCIAL-BASED EXERCISE MODEL VIA TELEREHABILITATION IN PATIENTS WITH INFLAMMATORY AND NON-INFLAMMATORY RHEUMATIC DISEASES: A PROSPECTIVE COHORT STUDY DURING THE COVID-19 PANDEMIC

Background

During the COVID-19 pandemic, the patients with rheumatic disease in the biopsychosocial perspective have been adversely affected by social isolation, uncertainty, and the thought that their chronic disease will worsen and increase in their symptoms. ACR/EULAR (American College of Rheumatology / European League Against Rheumatism) defines recommendations about continuing current pharmacotherapy and the significance of the biopsychosocial approach and exercise for patients with rheumatic diseases during a COVID-19 infection 1, 2.

Objectives

This study aims to investigate the effectiveness of the biopsychosocial exercise performed by telerehabilitation on biopsychosocial status, general health status, and anxiety-depression levels in the patients with inflammatory and non-inflammatory rheumatic diseases.

Methods

Fourteen patients with inflammatory rheumatic diseases (rheumatoid arthritis: 4; ankylosing spondylitis: 4; sjogren’s syndrome: 3; polymyalgia rheumatica: 2; and vasculitis: 1) and eight patients with non-inflammatory rheumatic diseases (fibromyalgia: 6; and osteoarthritis: 2) performed a biopsychosocial-based exercise model (named as “Bilişsel Egzersiz Terapi Yaklaşimi”-(BETY) in original; “Cognitive Exercise Therapy Approach” in English) via telerehabilitation continued for three sessions per week for 12 months 3. Outcome measures were Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), and BETY-Biopsychosocial Questionnaire (BETY-BQ) 4. All outcomes were measured baseline and at the 12th month. The Wilcoxon’s test was used for statistical analysis.

Results

All of the 22 patients were female. The mean age was 57.4 and 55.8 years in the inflammatory and non-inflammatory rheumatic diseases groups respectively, and they had a mean BMI of 25.9 and 25.3 kg/m2. There was no significant difference by time for HAQ score (p = 0.125), HADS anxiety and depression (p = 0.916 and p = 0.663, respectively), and BETY-BQ score (p = 0.753) between the baseline and at the 12th month follow-up in the patients with inflammatory rheumatic diseases. Similarly, in the patients with non-inflammatory rheumatic diseases, there was no significant difference by time for HAQ score (p = 0.546), HADS anxiety and depression (p = 0.343 and p = 0.527, respectively), and BETY-BQ score (p = 0.068) between the baseline and at the 12th month follow-up.

Conclusion

This study showed that biopsychosocial-based exercise through real-time telerehabilitation was able to maintain their conditions before pandemic in biopsychosocial status, general health, and anxiety-depression levels on the patients with inflammatory and non-inflammatory rheumatic diseases during COVID-19 pandemic period in one-year follow-up.

References

[1]England BR, Barber CE, Bergman M, Ranganath VK, Suter LG, Michaud K. Brief Report: adaptation of American College of Rheumatology Rheumatoid Arthritis Disease Activity and functional status measures for telehealth visits. Arthritis Care Res (Hoboken). 2020.

[2]Landewé RB, Machado PM, Kroon F, Bijlsma HW, Burmester GR, Carmona L, Combe B, Galli M, Gossec L, Iagnocco A. EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2. Ann Rheum Dis. 2020;79(7):851-8.

[3]Kisacik P, Unal E, Akman U, Yapali G, Karabulut E, Akdogan A. Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice. 2016;22:38-43.

[4]Edibe Ü, Gamze A, KARACA NB, KİRAZ S, AKDOĞAN A, KALYONCU U, ERTENLİ Aİ, BİLGEN ŞA, KARADAĞ Ö, ERDEN A. Romatizmali hastalar için bir yaşam kalitesi ölçeğinin geliştirilmesi: madde havuzunun oluşturulmasi. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67-75.

Disclosure of Interests

None declared

POS1071 DETERMINATION OF THE RELIABILITY AND VALIDITY OF THE BETY-BIOPSYCHOSOCIAL QUESTIONNAIRE IN PATIENTS WITH A DIAGNOSIS OF PSORIATIC ARTHRITIS

Background:

In the literature, there is a lack of questionnaires, which is evaluate patients with psoriatic arthritis (PsA) from a biopsychosocial perspective.

Objectives:

This study was planned to examine the reliability and validity of the BETY- Biopsychosocial Questionnaire (BQ) in individuals diagnosed with PsA.

Methods:

Test-retest method was used to examine the reliability of the BETY-BQ. In comparing the reliability of test-retest results, intraclass coefficient (ICC) was checked. For the internal consistency analysis of the BETY-BQ, the total score of the responses given to the first filled scale was calculated and the Cronbach’s Alpha coefficient was found. Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS) and Short Form-36 (SF-36) were used in the validity study of 150 individuals with PsA included in the study.

Results:

Test-retest method and intraclass coefficient were examined for reliability analysis (for 30 patients). The correlation (r = 0.844, p <0.001) of the answers given to the BETY-BQ by individuals with 30 PsA after one week interval was very high. While the ICC coefficient (0.915, p <0.001) showed excellent reliability. The Cronbach’s Alpha coefficient (0.940) was examined for internal consistency and the internal consistency of the scale was also found to be excellent. As a result of statistical analysis, the correlation between the scales used and the BETY-BQ was found between r = -0.432 and 0.807 (p <0.001).

Conclusion:

With this study, it was concluded that the BETY-BQ is a reliable and valid assessment tool in individuals diagnosed with PsA, and is also a biopsychosocial tool that can be used to evaluate individuals with PsA.

References:

[1]Unal E, Arin G, Karaca Nb, Kiraz S, Akdoğan A, Kalyoncu U, et al. Romatizmali hastalar için bir yaşam kalitesi ölceginin gelistirilmesi: madde havuzunun olussturulmasi. Journal of Exercise Theraphy and Rehabilitation. 2017;4(2):67-75.

[2]Husni ME, Merola JF, Davin S. The psychosocial burden of psoriatic arthritis. Semin Arthritis Rheum. 2017;47(3):351-60

Disclosure of Interests:

None declared.

FRI0619-HPR INVESTIGATION OF THE RELATIONSHIP BETWEEN BIOPSYCHOSOCIAL STATUS AND QUALITY OF LIFE, EMOTION - STATUS AND FUNCTIONALITY IN INDIVIDUALS WITH PSORIATIC ARTHRITIS

Background:

Due to the chronic processes of rheumatological diseases, patients’ biopsychosocial effects are revealed.

Objectives:

The aim of this study is to evaluate the biopsychosocial status of individuals diagnosed with psoriatic arthritis; to examine the relationship between quality of life, emotion - status and functionality.

Methods:

105 individuals were included in the study. To evaluate the biopsychosocial situation, BETY-BQ (Bilişsel Egzersiz Terapi Yaklaşimi – Biopsychosocial Questionnaire)(1); Psoriatic Arthritis Quality of Life (PsAQoL) Scale to assess quality of life; For the emotion-status assessment; Hospital Anxiety and Depression Scale (HADS-A, HADS-D); Health Assessment Questionnaire (HAQ) was used for functionality. Pearson Correlation Analysis was used in statistical analysis.

Results:

Descriptive data of the individuals participating in the study were recorded (Table 1).While BETY-BQ was highly correlated with PSAQoL Scale(r = 0.826, p <0.001), moderate correlations were found with HADS-A and HADS-D (HADS-A (r = 0.618, p <0.001), HADS-D (r = 0.507, p <0.001)). Low correlation was found between BETY-BQ and HAQ (r = 286, p = 0.003) (Table 2).

Table 1.

Descriptive Statistics

MinimumMaximumMeanStandart DeviationAge (years)206044.9811.04Height (cm)145.00190.00165.618.88Weight (kg)4413875.5417.36VKI(kg/m2)17.8549.0027.546.02Table 2.PsAQoLHADS-AHADS-DHAQBETY-BQr 0.826**p<0.001r=0.618**p<0.001r=0.507**p<0.001r=286**p=0.003

** Correlation is significant at the 0.01 level (2-tailed)

Conclusion:

In this study, it was found that BETY-BQ is a scale that can be used in total to evaluate the quality of life, emotion-status level and functionality of individuals diagnosed with PsA. It was thought that BETY-BQ could be considered and preferred by clinicians when individuals with PsA should be evaluated from a biopsychosocial point of view.

References:

[1] Unal E, Arin G, Karaca Nb, Kiraz S, Akdogan A, Kalyoncu U, et al. Development of a quality of life measurement for rheumatic patients: item pool construction Journal of Exercise Therapy and Rehabilitation. 2017; 4 (2): 67-75.

Disclosure of Interests:

Senem Bulut: None declared, Edibe Ünal: None declared, Aykut Özçadirci: None declared, Umut Kalyoncu Consultant of: Abbvie, Amgen, Janssen, Lilly, Novartis, UCB

AB0857 A NEW BIOPSYCHOSOCIAL QUESTIONNAIRE FOR PATIENTS WITH KNEE OSTEOARTHRITIS

Background:

OA is a problem that cartilage damage occurs, which leads to stiffness in the joint, pain and functional limitations (1). This problem can also cause psychosocial impact like other chronic diseases (2). As with other rheumatic diseases, this complex picture of inflammation required biopsychosocial approaches and measurement methods for knee OA.

Objectives:

This study was planned to investigate the validity and reliability of a new biopsychosocial questionnaire which is named Cognitive Exercise Therapy Approach Biopsychosocial Questionnaire (BETY-BQ) in individuals with knee osteoarthritis (OA).

Methods:

The study included 150 individuals who diagnosed knee osteoarthritis at stage 1 or 2 according to the Kellgren-Lawrence scale. For determining daily living activities; Health Assessment Questionnaire (HAQ), for quality of life Short Form-36 (SF-36) Quality of Life Scale, for anxiety and depression levels; Hospital Anxiety and Depression Scale (HADS), for severity of disease Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and for biopsychosocial evaluation BETY-BQ were used.

Results:

The correlation between BETY-BQ and other scales was examined by Spearman correlation analysis (r=-0.252, 0.633, p<0,05). Cronbach’s alpha coefficient and item-total correlation were used as reliability methods. Cronbach’s alpha coefficient was examined for the internal consistency of the scale and was found to be 0.887 for the first evaluation, 0.917 for measurements after 1 week and 0.843 for measurements after 3 months. Item total correlation, which was another indicator of reliability, ranged from 0.632 to 0.854 (p<0.05).

Table 1.

Correlation coefficients between all questionnaires and Cognitive Exercise Therapy Approach Biopsychosocial Questionnaire (BETY-BQ).

Spearman Correlation AnalysisCognitive Exercise Therapy Approach Biopsychosocial Questionnaire (BETY-BQ)rpWOMAC-Pain0,473<0,001WOMAC-Stiffness0,458<0,001WOMAC-Physical Function0,514<0,001WOMAC-Total Score0,553<0,001hospital anxiety and depression scale- anxiety0,615<0,001hospital anxiety and depression scale-depression0,2520,002*Health Assessment Questionnaire0,633<0,001Short Form-36 Role limitations due to physical health-0,440<0,001Short Form-36 Role limitations due to emotional problems-0,357<0,001Short Form-36 Physical functioning-0,469<0,001Short Form-36 Social functioning-0,355<0,001Short Form-36 Pain-0,487<0,001Short Form-36 General Health-0,513<0,001Short Form-36 Emotional well-being-0,508<0,001Short Form-36 Energy/fatigue-0,453<0,001

Conclusion:

As a result of our study, it was concluded that BETY-BQ is a valid and reliable biopsychosocial questionnaire in individuals with knee OA diagnosis. This result showed that BETY-BQ can be used in clinics to evaluate biopsychosocial involvement in patients with knee OA.

References:

[1]Hunter DJ, Felson DT. Clinical review: osteoarthritis. British Medical Journal [periódico online]. 2006:639-42

[2]Axford J, Butt A, Heron C, Hammond J, Morgan J, Alavi A, et al. Prevalence of anxiety and depression in osteoarthritis: use of the Hospital Anxiety and Depression Scale as a screening tool. Clinical rheumatology. 2010;29(11):1277-83.

Disclosure of Interests:

None declared

[Progressive multifocal leukoencephalopathy: a complication in chronic B-cell lymphatic leukaemia]

BACKGROUND

Progressive multifocal leukoencephalopathy (PML) is a rare infectious cause of sub-acute neurological symptoms, and occurs predominantly in immunocompromised patients. PML is caused by reactivation of the JC virus.

CASE DESCRIPTION

A 79-year-old man with a history of chronic B-cell lymphatic leukaemia (B-CLL) presented at our hospital with a neurological deficit of the left side of his body. He was initially diagnosed with a right-hemisphere stroke. Two months later he returned with progressive paresis and on an MRI of the brain we saw an increase in abnormalities of the white matter. On suspicion of PML we conducted PCR for JC virus on cerebrospinal fluid (CSF), which was negative. Histopathological investigations of a brain biopsy confirmed the diagnosis of PML, four months after he first presented.

CONCLUSION

PML is a rare cause of sub-acute neurological symptoms. PML can be difficult to diagnose as a PCR of CSF for JC virus in the early stages of PML can give a false negative result. If PML is suspected, histological investigation of a brain biopsy is necessary.

Genotype-phenotype correlation, gonadal malignancy risk, gender preference, and testosterone/dihydrotestosterone ratio in steroid 5-alpha-reductase type 2 deficiency: a multicenter study from Turkey

BACKGROUND

Studies regarding genetic and clinical characteristics, gender preference, and gonadal malignancy rates for steroid 5-alpha-reductase type 2 deficiency (5α-RD2) are limited and they were conducted on small number of patients.

OBJECTIVE

To present genotype-phenotype correlation, gonadal malignancy risk, gender preference, and diagnostic sensitivity of serum testosterone/dihydrotestosterone (T/DHT) ratio in patients with 5α-RD2.

MATERIALS AND METHODS

Patients with variations in the SRD5A2 gene were included in the study. Demographic characteristics, phenotype, gender assignment, hormonal tests, molecular genetic data, and presence of gonadal malignancy were evaluated.

RESULTS

A total of 85 patients were included in the study. Abnormality of the external genitalia was the most dominant phenotype (92.9%). Gender assignment was male in 58.8% and female in 29.4% of the patients, while it was uncertain for 11.8%. Fourteen patients underwent bilateral gonadectomy, and no gonadal malignancy was detected. The most frequent pathogenic variants were p.Ala65Pro (30.6%), p.Leu55Gln (16.5%), and p.Gly196Ser (15.3%). The p.Ala65Pro and p.Leu55Gln showed more undervirilization than the p.Gly196Ser. The diagnostic sensitivity of stimulated T/DHT ratio was higher than baseline serum T/DHT ratio, even in pubertal patients. The cut-off values yielding the best sensitivity for stimulated T/DHT ratio were ≥ 8.5 for minipuberty, ≥ 10 for prepuberty, and ≥ 17 for puberty.

CONCLUSION

There is no significant genotype-phenotype correlation in 5α-RD2. Gonadal malignancy risk seems to be low. If genetic analysis is not available at the time of diagnosis, stimulated T/DHT ratio can be useful, especially if different cut-off values are utilized in accordance with the pubertal status.

Gamete formation resets the aging clock in yeast

Gametogenesis is a process whereby a germ cell differentiates into haploid gametes. We found that, in budding yeast, replicatively aged cells remove age-induced cellular damage during gametogenesis. Importantly, gametes of aged cells have the same replicative potential as those derived from young cells, indicating that life span resets during gametogenesis. Here, we explore the potential mechanisms responsible for gametogenesis-induced rejuvenation and discuss putative analogous mechanisms in higher eukaryotes.

Comparing different revisions of the Childhood Health Assessment Questionnaire to reduce the ceiling effect and improve score distribution: Data from a multi-center European cohort study of children with JIA

BACKGROUND

The original version of the Childhood Health Assessment Questionnaire (CHAQ30orig) suffers from a ceiling effect and hence has reduced clinical validity. The purpose of this study was to evaluate the effect of adding eight more demanding items (CHAQ38) and a new categorical response option (CATII) on discriminant validity and score distribution in a European patient sample.

METHODS

Eighty-nine children with Juvenile Idiopathic arthritis (JIA) and 22 healthy controls, aged 7-16 years, were recruited from eight centres across Europe. Eight new CHAQ items and scoring option were translated back and forth for the countries in which they were not already present. Demographic, clinical, and CHAQ data were collected on-site. Subsequently, five different scoring methods were applied, i.e. the original method (CHAQ30orig) and four alternatives. These alternatives consisted of the mean item scores for the 30 and 38-question versions with either the original (CATI), or the new categorical response option (CATII). The five versions were tested for their ability to distinguish between patients and controls. Furthermore score distributions were evaluated and visualized by box and whisker plots.

RESULTS

Two CHAQ revisions with the new response option showed poor discriminative ability, whereas one revised version (CHAQ38CATI) had comparable discriminative ability comparable to the original CHAQ. A profound ceiling effect was observed in the original scoring method of the CHAQ (27%). The addition of eight more demanding items and application of a plain mean item score reduced this significantly to 14% (chi2 = 4.21; p < 0.05).

CONCLUSIONS

Revising the CHAQ by adding eight more demanding items and applying a plain mean item scoring (CHAQ38CATI) maintained discriminant ability and reduced the ceiling effect in a European patient sample. The new categorical response option (CATII) seemed promising, but was less able to distinguish children with JIA from healthy controls and had less favourable distribution characteristics. The CHAQ38CATI is advocated for future use in mildly affected JIA patients.