Secondary osteoporosis is a feature of rheumatoid arthritis (RA). In recent years, several attempts have been made to develop specific markers for monitoring connective tissue metabolism in arthritic diseases. Our purpose, in this study was to assess pyridinium crosslinks (PYD and DPYD) excretion in relation to the activity of RA (changes related to sulphasalazine treatment). Fourty premenopausal female patients with active RA (mean age; 36.0 7.2 years), 20 postmenopausal women with active RA (mean age; 60.0 6.8 years), 23 postmenopausal women with OA (mean age; 56.1 6.6 years) and 17 premenopausal healthy subjects (mean age; 28.3 4.28 years) were enrolled in our study. All of the 40 premenopausal female patients with active RA were given sulphasalazine. The mean follow up period for these patients was 10.3 1.1 months. In all of these patients, urine samples were collected both in the active and in the inactive periods. Urine PYD and DPYD levels were measured by ELISA. Urine PYD levels were significantly higher in the active period (14.01 3.16 nmol/mmol cr) than in the inactive (8.25 4.23 nmol/mmol cr) period in patients with premenopausal RA (p 0.05). Urine PYD levels were significantly high in postmenopausal active RA patients (19.06 3.26 nmol/mmol cr) compared to premenopausal active and ind inactive, postmenopausal inactive RA patients, osteoarthritis and healthy controls. Urine DPYD excretion was similar in patients with premenopausal RA in the active (7.46 2.13 nmol/mmol cr) and inactive periods (5.08 0.87 nmol/mmol cr) (p 0.05). In active premenopausal RA patients, a correlation was found between PYD excretion and RAI, ESR, CRP and functional capacity (r=0.5729 p 0.01, r=0.5953 p 0.01, r=0.6125 p 0.01 and r=0.6232, p 0.01 respectively). But in the inactive period, no such correlation was was evident. In disease activity parameters did not correlate with DPYD excretion in either the active or the inactive period. As a result, urine PYD excretion was significantly high in patients with active RA. During sulphasalazine treatment, urine PYD levels decreased. This is attributed to improvement in bone destruction.
Adrenal Cortex Hormones/adverse effects ; Adult ; Aged ; Amino Acids/*urine ; Arthritis, Rheumatoid/*urine ; Collagen/*urine ; Female ; Human ; Middle Age ; Osteoporosis/urine ; Sulfasalazine/*pharmacology

PURPOSE: Bullying behaviors experienced during nursing education negatively affect students, educators, quality of training, and patient care. The purpose of this study was to develop a valid, reliable, short, and comprehensive scale to measure the bullying behaviors of nursing students in the education environment. METHODS: The Bullying Behaviors in Nursing Education (BBNE) tool was developed by adapting the Workplace Psychological Violence Behaviors scale. The data were collected from 442 nursing students from April to May 2017. The BBNE was tested using structural equation modeling, and validity and reliability results were obtained. Moreover, complementary statistics were determined, and the violence behaviors experienced by nursing students were reported. RESULTS: The full BBNE scale, with 30 items and four factors, was not verified (χ²/df = 4.31); 12 items were excluded, and the modified structure with 18 items and four factors was verified (χ²/df = 2.60; root-mean-square error of approximation = .06). The scale's Cronbach's α coefficient is .88, and the structure reliability is .92. Twenty-five percent of the 442 students scored 1 or higher in the total scale, showing that they were subject to bullying behaviors. CONCLUSION: The BBNE scale can be used to measure the bullying behaviors of nursing students in the education environment. When such behaviors are identified, students can struggle on the personal and organization level. Providing a safer and comfortable education environment for nursing students who are the guarantee of the future of health care will positively affect the quality of education and patient care in parallel.
Bullying* ; Delivery of Health Care ; Education ; Education, Nursing* ; Humans ; Nursing* ; Patient Care ; Prevalence ; Reproducibility of Results ; Students, Nursing ; Violence