Low IGF-1 levels can be used to predict delirium after surgery. However, the complex nature of cytokines and delirium itself make it difficult to utilize cytokines to predict delirium instead of psychometric tools.

Reliability and validity of the Turkish translation of the Delirium Rating Scale-Revised-98Objective: Delirium is a common neuropsychiatric disorder. The Delirium Rating Scale-Revised-98 (DRS-R-98) is a widely used and well-validated delirium diagnostic and severity scale that has been translated into many languages. We investigated the reliability and validity of the Turkish version of the DRS-R-98.Method: Data for 30 consecutive delirium patients were obtained from consultation-liaison psychiatry referrals and 30 non-delirium patients were from routine screening following cardiovascular surgery. Two psychiatrist researchers diagnosed all cases using DSM-IV criteria, and independently administered the DRS-R-98 and Mini Mental State Examination (MMSE). Concurrent validity, interrater reliability, inter-battery factor analysis, internal consistency, sensitivity and specificity at various scale cut-off values were analyzed as well as descriptive analyses were performed.Results: Mean age was 70.2±15.4 and 62.8±12.6, and mean DRS-R-98 total score was 25.7±6.3 and 4.5±2.5 for delirium and non-delirium groups, respectively. Cronbachs' α intraclass coefficients measuring interrater reliability for DRS-R-98 severity and total scale scores were both 0.99 (SVD: 203.74; SVD: 282.98, respectively).DRS-R-98 severity scores were correlated with MMSE (r=-0.87, p<0.001 for both raters). Internal consistency was high for the DRS-R-98 (Cronbachs' α=0.964). Cut-off score of 16 for the DRS-R-98 total score had 100% sensitivity and 88.5% specificity, whereas 11 for the DRS-R-98 severity scale had 100% sensitivity and 85.7% specificity. Conclusion:We believe the DRS-R-98 Turkish version is a valid and reliable tool for clinicians and researchers. toplam için 16 kesme puanının duyarlılığı %100, özgüllüğü %88.5 iken, DRS-R-98 şiddet için 11 kesme puanının duyarlılığı %100, özgüllüğü %85.7 olarak bulunmuştur.Sonuç: DRS-R-98 Türkçe çevirisinin klinisyenler ve araştırmacılar için geçerli ve güvenilir olduğuna, yapılacak deliryum çalışmalarına katkıda bulunacağına inanmaktayız.

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Background Patients with systemic sclerosis (SSc) are affected physically and psychologically because of their disease. Hand involvement is seen in many patients with SSc. Hand dysfunction in SSc patients may be caused by Raynaud phenomenon (RP) with finger ulcers, arthralgia, arthritis, tendonitis, weakness and skin thickening, which cause loss of dexterity. SSc patients may present with hand dysfunction that cause difficulties in performing daily activities. Objectives To determine the challenges experienced by SSc women, whose hands affected, while performing activities of daily living and their coping strategies. Methods Seventeen patients with SSc whose hands affected were enrolled to this descriptive and cross-sectional study between April 2010 and December 2011. In addition to sclerodactyly, patients who had active digital ulcers, digital ulcer complications (pitting scars, digital amputation, digital necrosis), or digital contractures were all considered hand involvement. Skin thickness was assessed by means of the modified Rodnan skin score. The data were collected by using both a demographic data form and an evaluation of daily activity questionnaire (EDAQ). EDAQ consists of 102 daily activities in 11 dimensions, each containing 4–13 activities and questionnaire for coping strategies. Descriptive statistics are shown in numbers (n) and percentages (%) for the variables obtained by counting and in mean ± standard deviation for variables obtained by measurement. Results Mean age of 17 women was 49.71±11.74 (32-70) years. Duration of illness was 12.65±8.76 (1-31) years. Sixteen were married. Twelve did not have a paid job. One of them was retired. Seven had diffuse, 12 had limited scleroderma. Rodnan skin score mean value was 11.88±4.77. According to EDAQ the most scored dimensions that patients can do with no difficulty was “toileting”, some/much difficulty was “eating” and the dimension that patients unable to do “washing/clothes care”. In “eating” dimension the most difficult activities were “opening glass jar, opening juice bottle, opening bottle” requiring the movement of rotation. Their coping strategies for these activities were try to open with a towel, try to remove the edge of the palm with a knife, use the hand palm, help from someone else (spouse, neighbor, etc.). In “washing/clothes care” dimension the most difficult activities were “turning up hem of a skirt, washing up in bowl, cutting out material”. They use some coping strategies such as getting help from tailor, washing in the machine instead of hand washing. Conclusions Impaired hand function is related to activities of daily living difficulties. Therefore, many patients establish a variety of coping methods in order to do daily activities. Determining the appropriate methods of coping with and informing patients about this issue seems important in the rehabilitation of patients. Also, it is important to increase awareness of health professionals who provide counseling. In summary, the coping strategies used by patients can be helpful...

Objectives. Expressed emotion and family functioning have been reported as negative impacts of the caregiver burden, mostly in mental disorders. There are limited data available to explain how these factors affect caregiver burden particularly for those caring for rehabilitation patients. In this study, the relationship of family functioning and expressed emotion with the caregiver burden was examined. Methods. A total of 103 caregivers with a mean age of 43.1±13.8 years were participated in the study. The caregivers' demographic data, psychiatric symptomatology, subjective burden, expressed emotion, and family functioning were assessed using structured and semi-structured scales. Results. Expressed emotion level (R 2 =0.361, p<0.001), family functioning (R 2 =0.275, p=0.003) and caregiver gender (R 2 =0.361, p=0.004) were determined as significant contributory factors with the subjective burden. Conclusion. Psychological intervention programs focused on both expressed emotion and communication skills in family should be developed to reduce the caregiver burden.Eur Res J 2017;3(1):55-61