Sirzat Yesilkaya

Measures of pituitary gland and stalk: from neonate to adolescence.

Abstract Objective: The aim of this study is to provide normative data about pituitary diameters in a pediatric population. Pituitary imaging is important for the evaluation of the hypothalamo-pituitary axis defect. However, data about normal pituitary gland diameters and stalk are limited, especially in children. Structure and the measurements of pituitary gland and pituitary stalk may change due to infection, inflammation, or neoplasia. Methods: Among 14,854 cranial/pituitary gland magnetic resonance imaging scans performed from 2011 to 2013, 2755 images of Turkish children aged between 0 and 18 were acquired. After exclusions, 517 images were left. Four radiologists were educated by an experienced pediatric radiologist for the measurement and assessment of the pituitary gland and pituitary stalk. Twenty cases were measured by all radiologists for a pilot study and there was no interobserver variability. Results: There were 10–22 children in each age group. The maximum median height of the pituitary gland was 8.48±1.08 and 6.19±0.88 mm for girls and boys, respectively. Volumes were also correlated with gender similar to height. Minimum median height was 3.91±0.75 mm for girls and 3.81±0.68 mm for boys. The maximum and minimum pituitary stalk basilar artery ratios for girls were 0.73±0.12 and 0.59±0.10 mm. The ratios for boys were 0.70±0.12 and 0.56±0.11 mm. Conclusion: Our study demonstrated the pituitary gland and stalk size data of children in various age groups from newborn to adolescent. It is thought that these data can be applied in clinical practice. Future prospective follow-up studies with larger samples, which correlate the structural findings with the clinical and laboratory results are awaited.

PReS-FINAL-2204: Developing of a new scale for assessing the adherence to colchicines treatment in pediatric patients with FMF

Familial Mediterranean Fever (FMF) is a disease characterized by attacks and colchicine is the medication considered most effective in reducing the intensity and frequency of attacks. Adherence to the medication regiment is important not only to manage FMF symptoms, but also to prevent amyloidosis.

Validity and reliability of medication adherence scale in FMF (adult version)

MASIF (Medication Adherence Scale in FMF) is an instrument designed to measure adherence to treatment in children with Familial Mediterranean Fever (FMF). We have developed this scale for children with FMF and found valid and reliable.

Validity and reliability of medication adherence scale in FMF

Objective The optimal level of adherence necessary to achieve acceptable disease and quality-of-life outcomes for patients is not known. In order to identify these optimal levels, we need reliable and valid measures of adherence. Medication Adherence Scale in FMF (MASIF) is an instrument designed to measure adherence to treatment in children with Familial Mediterranean Fever (FMF). We have developed this scale for children with FMF and found valid and reliable. In this study, it was aimed to assess the validity and reliability of this adherence scale for medical treatment in adult FMF patients.

Developing of a new scale for assessing the adherence to colchicine treatment in pediatric patients with FMF.

Familial Mediterranean Fever (FMF) is a disease characterized by attacks and colchicine is the medication considered most effective in reducing the intensity and frequency of attacks. Adherence to the medication regiment is important not only to manage FMF symptoms, but also to prevent amyloidosis.

AB1118 Validity and Reliability of Medication Adherence Scale in FMF (Adult Version)

Background The optimal level of adherence necessary to achieve acceptable disease and quality-of-life outcomes for patients is not known. In order to identify these optimal levels, we need reliable and valid measures of adherence. Medication Adherence Scale in FMF (MASIF) is an instrument designed to measure adherence to treatment in children with FMF. We have developed this scale for children with FMF and found valid and reliable (1). Objectives It was aimed to assess the validity and reliability of this adherence scale for medical treatment in adult FMF patients. Methods This study is multicentre and 14 centers participated to the study. Patients with FMF using medication at least for 6 months and accepted to participate constituted the sample of the study. Besides “Medication Adherence Scale in FMF Patients (MASIF)”, “Data collection forms about the sociodemographic and medical information (demographic, clinical and laboratory findings) of patients”, was used as data collection instruments. Morisky medication adherence scale was used as a gold standard in order to evaluate the criterion validity of MASIF. We assessed the validity of the adult version of the MASIF using the OMERACT filter. Results The median age of the patients (n=133) was 28.60 years (min.18.12-max.71.34) and 52.6% of them were female. For internal consistency, Cronbachs alpha was 0,764 for MASIF adult version. Also, there was a positive and significant correlation between test and retest score (t=0.971; p=0.340). For the “criterion validity” the correlation with Morisky and MASIF was evaluated (r=0.530, p=0.000) and for the “structure” validity, factor analyzes and Kaiser-Meyer-Olkin tests were performed. After these tests, MASIF was found as a valid and reliable instrument. MASIF consists of 18 items and 4 sub-dimensions: knowledge about the medication, adherence to the treatment, barriers to drug use, factors that may increase compliance. The total score ranged from 18 to 90. A high score showed a good adherence to treatment. The cut-off point was determined as 55 points. A point over 55 was accepted as “good medication adherence” and a point less than 55 was considered as “bad medication adherence” Conclusions Approximately 10-15% of patients with FMF are non-responders but it was claimed that in fact they are non-compliers that causes these patients receive unnecessary biologic agent treatment procedures, which are expensive and have some serious adverse effects. This scale will provide assessment and follow up of adherence to treatment patients and determine whether the patient is non-responders or non-compliers. It may help to determine the non-compliance and prevent unnecessary and expensive biologic agents. Disclosure of Interest None declared

PReS-FINAL-2213: Validation of inadequate drug response and definition of colchicum resistance in FMF

Colchicine is effective in controlling the attacks and preventing the development of amyloidosis. Moreover many new generation drugs may be used in FMF treatment. About 5-10% of the patients do not respond to colchicine and inadequate response to other drugs is not as clear as the unresponsiveness of colchicine.