Aim: The objective of this study was to determine whether regular combined exercise program, whic... more Aim: The objective of this study was to determine whether regular combined exercise program, which consists strength, stretching and aerobic exercises and additional jumping training, improve balance, fall risk, quality of life and depression status of older people living in a residential care. Methods: A total of 168 residents who live in a long term care facility were screened. The trial began with 78 eligible participants and they were randomly grouped as combined exercises program (COM) group that includes stretching, strength and aerobic exercises, and COM plus jumping (COMpJ) group. 66 of the participants finished the trial. The groups were convened three times a week for six weeks. Each group had a warm-up, effective training and a cooling down periods. The total exercising time was no longer than 45 minutes in each group. Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk, short form 36 (SF 36) for the health related quality of life and Geriatric Depression Scale (GDS) for evaluation of the depression status were used. Results: The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial; however, the improvements were statistically better in jumping combined group. Also health related quality of life improved in both groups. Conclusion: Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement, fall risk reduction and quality of life. The addition of jumping to strength, stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction.
Fiziksel tıp ve rehabilitasyon bilimleri dergisi, 2009
Derleme / Review ÖZET Ayd›nlat›lm›fl onam (bilgilendirilmifl r›za), hastan›n kendisine gerçeklefl... more Derleme / Review ÖZET Ayd›nlat›lm›fl onam (bilgilendirilmifl r›za), hastan›n kendisine gerçeklefltirilecek t›bbi uygulama konusunda anlaya-ca¤› flekilde bilgilendirildikten sonra, t›bbi uygulaman›n gerçeklefltirilmesi konusunda serbestçe karar vermesini amaçlar. Ayd›nlat›lm›fl onam, yasal bir zorunluluk olman›n ötesinde, ça¤dafl t›p eti¤i ve uygulamalardan oluflan ahlaki bir ö¤retidir. Birçok hasta t›bbi durumlar› ve uygulanmas› planlanan tedavi hakk›nda bilgi ve seçenek sahibi olmak ister. T›bbi uygulamalarla ilgili bilgilendirme, uygulama k›s›tl›l›klar›n›n anlat›lmas› ve hasta merkezli tedavi onay› ça¤dafl t›p eti¤inin gerektirdi¤i durumlard›r. Bununla birlikte, ayd›nlat›lm›fl onam›n yaz›l› ve sözlü olmas› ile içeri¤inin kapsam› konusundaki etik ve hukuki tart›flmalar halen devam etmektedir. Ayd›nlat›lm›fl onam›n yaz›l› olmas›n›n hasta aç›s›ndan birtak›m sak›ncalar oluflturabilece¤i bilinmekle birlikte, günümüzde mevcut baz› t›bbi olaylar hakk›ndaki hukuki kararlar yaz›l› ayd›nlat›lm›fl onam al›nmas›n› ispat aç›s›ndan kaç›n›lmaz konuma getirmifltir. Bu yaz›da hekim-hasta iletiflimini güçlendiren ayd›nlat›lm›fl onam kavram› etik ve hukuki boyutlar›yla gözden geçirilmifl ve kas-iskelet ile sinir sistemi hastal›klar›nda genifl bir uygulama alan›na sahip Fiziksel T›p ve Rehabilitasyon disiplininde s›k kullan›lan invaziv ve non-invaziv tedavi yaklafl›mlar› için model teflkil edebilecek yaz›l› ayd›nlat›lm›fl onam formlar› sunulmufltur. (FTR Bil Der 2009;12:140-50) Anahtar kelimeler: Ayd›nlat›lm›fl onam, hekim hasta iliflkisi, fiziyatri, fiziksel t›p ve rehabilitasyon ABSTRACT The aim of informed consent is to enable patients to decide upon the treatment with his/her own freewill after being clearly and adequately informed about the recommended treatment. Informed consent is a moral principle that is composed of contemporary medical ethics and administrations beyond being a regulatory obligation. Many patients demand information and options about the medical condition and planned treatment. Information about the medical practice and explanation about its limitations as well as the patient-centered consents are the necessities of the modern medical ethics. Furthermore, the ethical and legal arguments about the written and oral forms of informed consent and the comprehensiveness of their content are still proceeding. Even though, the written form of the informed consent may induce some inconvenience for the patients, due to the legal judgments about some medical conditions in today's practices, having written informed consent has become inevitable to constitute evidence. In this paper, the conception of informed consent, which strengthens the patient-physician relationship, is revised considering its ethical and legal aspects, and some written informed consent forms, which may constitute models for the approaches of the invazive and non-invazive therapeutic procedures in Physical Medicine and Rehabilitation that have a considerable therapeutic area in musculoskeletal and nervous system disesases are presented. (JPMRS 2009;12:140-50)
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, 2011
Girifl: Evlilik, yafll› sa¤l›¤› üzerinde önemli etkiye sahip bir faktördür. Hiç evlenmemifl, dul ... more Girifl: Evlilik, yafll› sa¤l›¤› üzerinde önemli etkiye sahip bir faktördür. Hiç evlenmemifl, dul veya boflanm›fllarla karfl›laflt›r›ld›¤›nda evli olma durumu daha iyi sa¤l›k kalitesi aç›s›ndan önemli bir sosyal faktör olarak tan›mlanm›flt›r. Bu çal›flman›n amac›, yafll›larda hayat kalitesi, denge ve düflme riski ile psikolojik iyilik hali üzerine medeni durumun etkilerini araflt›rmakt›r. Gereç ve Yöntem: Çal›flmaya bak›mevinde yaflayan 100 birey dahil edildi (38 evli, 62 bekar, ortalama yafl 80.54±6.33 y›l, yafl aral›¤› 65-96 y›l). Dinamik denge ve düflme riski Biodeks Denge Sistemi, sa¤l›kla iliflkili hayat kalitesinin de¤erlendirilmesi k›sa form 36 (KF 36) ile yap›ld›. Psikolojik iyilik halinin de¤erlendirilmesi için geriatrik depresyon skalas› (GDS) kullan›ld›. Bulgular: Evli grupta, yafl ayarlamas› yap›ld›ktan sonra yap›lan de¤erlendirmede KF36'n›n fiziksel fonksiyon, sosyal fonksiyon ve genel mental sa¤l›k alt skala skorlar›, postural stabilite testinin anterior/posterior s...
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, 2015
B‹SFOSFONAT TEDAV‹S‹ ALAN B‹R HASTADA RAD‹KÜLOPAT‹ VE KALÇA OSTEOARTR‹T‹N‹ TAKL‹T EDEN AT‹P‹K FEM... more B‹SFOSFONAT TEDAV‹S‹ ALAN B‹R HASTADA RAD‹KÜLOPAT‹ VE KALÇA OSTEOARTR‹T‹N‹ TAKL‹T EDEN AT‹P‹K FEMUR KIRI⁄I: OLGU SUNUMU ABSTRACT Bisphosphonates are the most commonly used drugs in the treatment of osteoporosis. Several randomized controlled studies have proved their effectiveness in the treatment of postmenopausal osteoporosis and today BPs are considered a first-line therapy for osteoporosis. Bisphosphonates inhibit osteoclastic activity, decrease bone turnover and increase bone mineral density. Although there is strong evidence that bisphosphonates prevent osteoporotic fractures, in recent years, there have been several reports that show the increasing risk of atypical femoral fractures that is related to prolonged usage (5 years or longer) of bisphosphonates. This may be related to prolonged suppression of bone turnover. By suppressing the bone turnover they impair the ability of bone to repair the microdamages and leads the accumulation of microcracs. In this case, we report 67...
Bu çalışmada orta veya ağır karpal tünel sendromu (KTS) hastalarında el bileğinin fleksiyon, ekst... more Bu çalışmada orta veya ağır karpal tünel sendromu (KTS) hastalarında el bileğinin fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviyasyon kas gücünün izokinetik özellikleri araştırıldı. Hastalar ve yöntemler: Ocak 2016-Nisan 2016 tarihleri arasında yapılan bu çalışmada orta veya ağır KTS olan 13 hasta (23 el) (2 erkek, 11 kadın; ort. yaş 45 yıl; dağılım 29-60 yıl) ile altı sağlıklı kontrol deneği (12 el) (2 erkek, 4 kadın; ort. yaş 41 yıl; dağılım 27-63 yıl) karşılaştırıldı. El bileği fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviasyon kas gücü izokinetik dinamometre ile 30º/saniye (5 set) açısal hızda ölçüldü. Kavrama gücü el dinamometresi ile (kilogram) ölçüldü. Klinik değerlendirme için Boston Anketi kullanıldı. Bulgular: Karpal tünel sendromu hastalarında kavrama gücü (p= 0.003); el bileği fleksiyonu 30º/saniye (p= 0.014); ekstansiyonu 30º/saniye (p= 0.016) ve ulnar deviasyonu 30º/saniye (p= 0.017) kas güçleri kontrol grubuna göre daha düşük idi. Semptom süresine göre yapılan değerlendirme, izokinetik testlerde pronasyon 30º/saniye (p=0.039, r=-0.432) ve ulnar deviasyon 30º/saniye (p= 0.034, r= 0.443) dışında KTS hastalarında anlamlı ilişki göstermedi. Boston Anketi, kavrama gücü ve izokinetik test sonuçları arasında anlamlı ilişki saptanmadı. Sonuç: El bileği kas gücünün izokinetik dinamometreler ile sayısal olarak ölçülmesi KTS hastalarının konservatif egzersiz tedavileri ve motor değerlendirmelerinde faydalıdır.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2016
This study aims to investigate the accuracy and effectiveness of blind and fluoroscopic-guided in... more This study aims to investigate the accuracy and effectiveness of blind and fluoroscopic-guided intra-articular shoulder injections in patients with shoulder pain. The study included 17 patients (6 males, 11 females; mean age 52.6±9.9 years; range 36 to 66 years) with shoulder pain more than three months. First intra-articular joint injections were performed with anterior approach blindly. Following the injection and after confirming that the needle tip was intra-articular with fluoroscopy and contrast distribution, the procedure was completed using 3 mL of local anesthetic (prilocaine and bupivacaine) and 1 mL of steroid (40 mg methylprednisolone). When the contrast distribution was observed to be extra-articular at the first administration, a second injection was continued under fluoroscopy guidance. All of the injections were intra-articular with the continuation of the procedure. Pain intensity was measured with visual analog scale (VAS). According to the contrast distribution vi...
Reported here is a 37-yr-old professional diving instructor who had developed complaints of back ... more Reported here is a 37-yr-old professional diving instructor who had developed complaints of back pain and weakness in the lower extremities after diving. He was eventually diagnosed as having spinal cord decompression sickness along with a likely diagnosis of anterior spinal artery (artery of Adamkiewicz) syndrome. Additionally, since the transthoracic echocardiography revealed patent foramen ovale, we hypothesized that it might have been a potential route for gas bubbles to occlude the anterior spinal artery in this diver.
ABSTRACT Objectives. To investigate the relationship between enthesitis and disease activity, fun... more ABSTRACT Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
We report a 20-year-old man with Poland syndrome who suffered from weakness, pain, numbness, and ... more We report a 20-year-old man with Poland syndrome who suffered from weakness, pain, numbness, and discoloration in the left upper extremity. He was eventually diagnosed as also having thoracic outlet syndrome. The concomitance of these two disorders is discussed with a special emphasis on the underlying mechanisms.
To investigate the relationship between enthesitis and disease activity, functional status, fatig... more To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
To investigate the relationship between enthesitis and disease activity, functional status, fatig... more To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
Two male patients aged 9 and 16 years were admitted with complaints of ankle pain and intoeing. T... more Two male patients aged 9 and 16 years were admitted with complaints of ankle pain and intoeing. There was no history of trauma and arthritis. In the first case, radiography examination revealed a “C sign” (a cortical continuity from the medial portion of the talus to the sustentaculum tali), a narrowing in the middle subtalar joint space, and convexity in the lower margin of the sustentaculum tali (Figure 1). Magnetic resonance imaging (MRI) showed triple coalition in the anterior subtalar joint (talocalcaneonavicular joint) in the first case (Figures 2 and 3) and fibrocartilaginous coalition at the posterior subtalar joint in the second case (Figure 4). Narrowing in the joint spaces, findings of early degeneration, and medullary edema in the adjacent bone were observed at the sites of coalition (Figures 3 and 4). Nonoperative treatment, such as physical therapy, exercises, and analgesic medication were applied. Tarsal coalition is one of the most important causes of pes planus and ...
Painful conditions of the musculoskeletal system are encountered quite frequently and are general... more Painful conditions of the musculoskeletal system are encountered quite frequently and are generally benign. However, clinicians should be careful to exclude rare malignant disorders and soft tissue sarcomas such as rhabdomyosarcoma, which have no specific symptoms or findings. This paper presents a case that was initially consistent with a hematoma but was then diagnosed as a rhabdomyosarcoma upon clinical examination and ultrasonography at follow-up shortly after.
A 23-year-old male patient presented to our clinic with pain and limited motion in the right hip.... more A 23-year-old male patient presented to our clinic with pain and limited motion in the right hip. The pain start ed about 3 years previously and increased over time, spreading to the trochanteric region of the right hip and the right groin. The characteristic of the pain was mechanical. He did not feel pain while sleeping. Prolonged sitting or standing caused the hip to lock. Previously, he had received physical therapy and analgesic medications but there had been no significant improvement. There was no pain in any other joint, and there was no history of disease or trauma associated with the hip. Physical examination revealed an antalgic gait. Palpation of the iliopsoas muscle caused pain. The motion of the right hip joint was limited and painful in all directions, whereas lumbar and left hip joint motions were unrestricted and painless. There were no neurological deficits of the lower extremities. Radiography of the pelvis indicated a narrowing joint space, and there were erosion...
Aim: The objective of this study was to determine whether regular combined exercise program, whic... more Aim: The objective of this study was to determine whether regular combined exercise program, which consists strength, stretching and aerobic exercises and additional jumping training, improve balance, fall risk, quality of life and depression status of older people living in a residential care. Methods: A total of 168 residents who live in a long term care facility were screened. The trial began with 78 eligible participants and they were randomly grouped as combined exercises program (COM) group that includes stretching, strength and aerobic exercises, and COM plus jumping (COMpJ) group. 66 of the participants finished the trial. The groups were convened three times a week for six weeks. Each group had a warm-up, effective training and a cooling down periods. The total exercising time was no longer than 45 minutes in each group. Berg balance test and Biodex Balance System for the assessment of the dynamic balance and fall risk, short form 36 (SF 36) for the health related quality of life and Geriatric Depression Scale (GDS) for evaluation of the depression status were used. Results: The balance improvement and fall risk reduction were observed in both of the groups at the end of the trial; however, the improvements were statistically better in jumping combined group. Also health related quality of life improved in both groups. Conclusion: Regular group exercise in a long term care facility have several beneficial effects on the elderly residents in regard to balance improvement, fall risk reduction and quality of life. The addition of jumping to strength, stretching and aerobic exercises provides important contributions to balance improvement and fall risk reduction.
Fiziksel tıp ve rehabilitasyon bilimleri dergisi, 2009
Derleme / Review ÖZET Ayd›nlat›lm›fl onam (bilgilendirilmifl r›za), hastan›n kendisine gerçeklefl... more Derleme / Review ÖZET Ayd›nlat›lm›fl onam (bilgilendirilmifl r›za), hastan›n kendisine gerçeklefltirilecek t›bbi uygulama konusunda anlaya-ca¤› flekilde bilgilendirildikten sonra, t›bbi uygulaman›n gerçeklefltirilmesi konusunda serbestçe karar vermesini amaçlar. Ayd›nlat›lm›fl onam, yasal bir zorunluluk olman›n ötesinde, ça¤dafl t›p eti¤i ve uygulamalardan oluflan ahlaki bir ö¤retidir. Birçok hasta t›bbi durumlar› ve uygulanmas› planlanan tedavi hakk›nda bilgi ve seçenek sahibi olmak ister. T›bbi uygulamalarla ilgili bilgilendirme, uygulama k›s›tl›l›klar›n›n anlat›lmas› ve hasta merkezli tedavi onay› ça¤dafl t›p eti¤inin gerektirdi¤i durumlard›r. Bununla birlikte, ayd›nlat›lm›fl onam›n yaz›l› ve sözlü olmas› ile içeri¤inin kapsam› konusundaki etik ve hukuki tart›flmalar halen devam etmektedir. Ayd›nlat›lm›fl onam›n yaz›l› olmas›n›n hasta aç›s›ndan birtak›m sak›ncalar oluflturabilece¤i bilinmekle birlikte, günümüzde mevcut baz› t›bbi olaylar hakk›ndaki hukuki kararlar yaz›l› ayd›nlat›lm›fl onam al›nmas›n› ispat aç›s›ndan kaç›n›lmaz konuma getirmifltir. Bu yaz›da hekim-hasta iletiflimini güçlendiren ayd›nlat›lm›fl onam kavram› etik ve hukuki boyutlar›yla gözden geçirilmifl ve kas-iskelet ile sinir sistemi hastal›klar›nda genifl bir uygulama alan›na sahip Fiziksel T›p ve Rehabilitasyon disiplininde s›k kullan›lan invaziv ve non-invaziv tedavi yaklafl›mlar› için model teflkil edebilecek yaz›l› ayd›nlat›lm›fl onam formlar› sunulmufltur. (FTR Bil Der 2009;12:140-50) Anahtar kelimeler: Ayd›nlat›lm›fl onam, hekim hasta iliflkisi, fiziyatri, fiziksel t›p ve rehabilitasyon ABSTRACT The aim of informed consent is to enable patients to decide upon the treatment with his/her own freewill after being clearly and adequately informed about the recommended treatment. Informed consent is a moral principle that is composed of contemporary medical ethics and administrations beyond being a regulatory obligation. Many patients demand information and options about the medical condition and planned treatment. Information about the medical practice and explanation about its limitations as well as the patient-centered consents are the necessities of the modern medical ethics. Furthermore, the ethical and legal arguments about the written and oral forms of informed consent and the comprehensiveness of their content are still proceeding. Even though, the written form of the informed consent may induce some inconvenience for the patients, due to the legal judgments about some medical conditions in today's practices, having written informed consent has become inevitable to constitute evidence. In this paper, the conception of informed consent, which strengthens the patient-physician relationship, is revised considering its ethical and legal aspects, and some written informed consent forms, which may constitute models for the approaches of the invazive and non-invazive therapeutic procedures in Physical Medicine and Rehabilitation that have a considerable therapeutic area in musculoskeletal and nervous system disesases are presented. (JPMRS 2009;12:140-50)
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, 2011
Girifl: Evlilik, yafll› sa¤l›¤› üzerinde önemli etkiye sahip bir faktördür. Hiç evlenmemifl, dul ... more Girifl: Evlilik, yafll› sa¤l›¤› üzerinde önemli etkiye sahip bir faktördür. Hiç evlenmemifl, dul veya boflanm›fllarla karfl›laflt›r›ld›¤›nda evli olma durumu daha iyi sa¤l›k kalitesi aç›s›ndan önemli bir sosyal faktör olarak tan›mlanm›flt›r. Bu çal›flman›n amac›, yafll›larda hayat kalitesi, denge ve düflme riski ile psikolojik iyilik hali üzerine medeni durumun etkilerini araflt›rmakt›r. Gereç ve Yöntem: Çal›flmaya bak›mevinde yaflayan 100 birey dahil edildi (38 evli, 62 bekar, ortalama yafl 80.54±6.33 y›l, yafl aral›¤› 65-96 y›l). Dinamik denge ve düflme riski Biodeks Denge Sistemi, sa¤l›kla iliflkili hayat kalitesinin de¤erlendirilmesi k›sa form 36 (KF 36) ile yap›ld›. Psikolojik iyilik halinin de¤erlendirilmesi için geriatrik depresyon skalas› (GDS) kullan›ld›. Bulgular: Evli grupta, yafl ayarlamas› yap›ld›ktan sonra yap›lan de¤erlendirmede KF36'n›n fiziksel fonksiyon, sosyal fonksiyon ve genel mental sa¤l›k alt skala skorlar›, postural stabilite testinin anterior/posterior s...
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, 2015
B‹SFOSFONAT TEDAV‹S‹ ALAN B‹R HASTADA RAD‹KÜLOPAT‹ VE KALÇA OSTEOARTR‹T‹N‹ TAKL‹T EDEN AT‹P‹K FEM... more B‹SFOSFONAT TEDAV‹S‹ ALAN B‹R HASTADA RAD‹KÜLOPAT‹ VE KALÇA OSTEOARTR‹T‹N‹ TAKL‹T EDEN AT‹P‹K FEMUR KIRI⁄I: OLGU SUNUMU ABSTRACT Bisphosphonates are the most commonly used drugs in the treatment of osteoporosis. Several randomized controlled studies have proved their effectiveness in the treatment of postmenopausal osteoporosis and today BPs are considered a first-line therapy for osteoporosis. Bisphosphonates inhibit osteoclastic activity, decrease bone turnover and increase bone mineral density. Although there is strong evidence that bisphosphonates prevent osteoporotic fractures, in recent years, there have been several reports that show the increasing risk of atypical femoral fractures that is related to prolonged usage (5 years or longer) of bisphosphonates. This may be related to prolonged suppression of bone turnover. By suppressing the bone turnover they impair the ability of bone to repair the microdamages and leads the accumulation of microcracs. In this case, we report 67...
Bu çalışmada orta veya ağır karpal tünel sendromu (KTS) hastalarında el bileğinin fleksiyon, ekst... more Bu çalışmada orta veya ağır karpal tünel sendromu (KTS) hastalarında el bileğinin fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviyasyon kas gücünün izokinetik özellikleri araştırıldı. Hastalar ve yöntemler: Ocak 2016-Nisan 2016 tarihleri arasında yapılan bu çalışmada orta veya ağır KTS olan 13 hasta (23 el) (2 erkek, 11 kadın; ort. yaş 45 yıl; dağılım 29-60 yıl) ile altı sağlıklı kontrol deneği (12 el) (2 erkek, 4 kadın; ort. yaş 41 yıl; dağılım 27-63 yıl) karşılaştırıldı. El bileği fleksiyon, ekstansiyon, supinasyon, pronasyon, radial ve ulnar deviasyon kas gücü izokinetik dinamometre ile 30º/saniye (5 set) açısal hızda ölçüldü. Kavrama gücü el dinamometresi ile (kilogram) ölçüldü. Klinik değerlendirme için Boston Anketi kullanıldı. Bulgular: Karpal tünel sendromu hastalarında kavrama gücü (p= 0.003); el bileği fleksiyonu 30º/saniye (p= 0.014); ekstansiyonu 30º/saniye (p= 0.016) ve ulnar deviasyonu 30º/saniye (p= 0.017) kas güçleri kontrol grubuna göre daha düşük idi. Semptom süresine göre yapılan değerlendirme, izokinetik testlerde pronasyon 30º/saniye (p=0.039, r=-0.432) ve ulnar deviasyon 30º/saniye (p= 0.034, r= 0.443) dışında KTS hastalarında anlamlı ilişki göstermedi. Boston Anketi, kavrama gücü ve izokinetik test sonuçları arasında anlamlı ilişki saptanmadı. Sonuç: El bileği kas gücünün izokinetik dinamometreler ile sayısal olarak ölçülmesi KTS hastalarının konservatif egzersiz tedavileri ve motor değerlendirmelerinde faydalıdır.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2016
This study aims to investigate the accuracy and effectiveness of blind and fluoroscopic-guided in... more This study aims to investigate the accuracy and effectiveness of blind and fluoroscopic-guided intra-articular shoulder injections in patients with shoulder pain. The study included 17 patients (6 males, 11 females; mean age 52.6±9.9 years; range 36 to 66 years) with shoulder pain more than three months. First intra-articular joint injections were performed with anterior approach blindly. Following the injection and after confirming that the needle tip was intra-articular with fluoroscopy and contrast distribution, the procedure was completed using 3 mL of local anesthetic (prilocaine and bupivacaine) and 1 mL of steroid (40 mg methylprednisolone). When the contrast distribution was observed to be extra-articular at the first administration, a second injection was continued under fluoroscopy guidance. All of the injections were intra-articular with the continuation of the procedure. Pain intensity was measured with visual analog scale (VAS). According to the contrast distribution vi...
Reported here is a 37-yr-old professional diving instructor who had developed complaints of back ... more Reported here is a 37-yr-old professional diving instructor who had developed complaints of back pain and weakness in the lower extremities after diving. He was eventually diagnosed as having spinal cord decompression sickness along with a likely diagnosis of anterior spinal artery (artery of Adamkiewicz) syndrome. Additionally, since the transthoracic echocardiography revealed patent foramen ovale, we hypothesized that it might have been a potential route for gas bubbles to occlude the anterior spinal artery in this diver.
ABSTRACT Objectives. To investigate the relationship between enthesitis and disease activity, fun... more ABSTRACT Objectives. To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). Methods. A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Results. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Conclusions. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
We report a 20-year-old man with Poland syndrome who suffered from weakness, pain, numbness, and ... more We report a 20-year-old man with Poland syndrome who suffered from weakness, pain, numbness, and discoloration in the left upper extremity. He was eventually diagnosed as also having thoracic outlet syndrome. The concomitance of these two disorders is discussed with a special emphasis on the underlying mechanisms.
To investigate the relationship between enthesitis and disease activity, functional status, fatig... more To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
To investigate the relationship between enthesitis and disease activity, functional status, fatig... more To investigate the relationship between enthesitis and disease activity, functional status, fatigue, joint mobility, radiological damage, laboratory parameter and quality of life in patients with ankylosing spondylitis (AS). A total of 421 patients with AS (323 male and 98 female) who were included in the Turkish League Against Rheumatism Registry were enrolled in the study. The Bath AS Disease Activity Index (BASDAI), fatigue, the Bath AS Functional Index (BASFI), the Bath AS Metrology Index (BASMI), the Maastricht AS Enthesitis Score (MASES), AS quality of life (ASQoL), the Bath AS Radiology Index (BASRI) and erythrocyte sedimentation rate (ESR) were evaluated. Enthesitis was detected in 27.3% of patients. There were positive correlations between MASES and BASDAI, BASFI and fatigue (p < 0.05). MASES was not correlated with BASRI, BASMI, ASQoL and ESR. The mean MASES score was 1.1 ± 2.4. The most frequent regions of enthesopathies were right iliac crest, spinous process of L5 and proximal to the insertion of left achilles tendon, respectively. Enthesitis was found to be associated with higher disease activity, higher fatigue, worse functional status and lower disease duration. As enthesitis was correlated with BASDAI, we conclude that enthesitis can reflect the disease activity in patients with AS.
Two male patients aged 9 and 16 years were admitted with complaints of ankle pain and intoeing. T... more Two male patients aged 9 and 16 years were admitted with complaints of ankle pain and intoeing. There was no history of trauma and arthritis. In the first case, radiography examination revealed a “C sign” (a cortical continuity from the medial portion of the talus to the sustentaculum tali), a narrowing in the middle subtalar joint space, and convexity in the lower margin of the sustentaculum tali (Figure 1). Magnetic resonance imaging (MRI) showed triple coalition in the anterior subtalar joint (talocalcaneonavicular joint) in the first case (Figures 2 and 3) and fibrocartilaginous coalition at the posterior subtalar joint in the second case (Figure 4). Narrowing in the joint spaces, findings of early degeneration, and medullary edema in the adjacent bone were observed at the sites of coalition (Figures 3 and 4). Nonoperative treatment, such as physical therapy, exercises, and analgesic medication were applied. Tarsal coalition is one of the most important causes of pes planus and ...
Painful conditions of the musculoskeletal system are encountered quite frequently and are general... more Painful conditions of the musculoskeletal system are encountered quite frequently and are generally benign. However, clinicians should be careful to exclude rare malignant disorders and soft tissue sarcomas such as rhabdomyosarcoma, which have no specific symptoms or findings. This paper presents a case that was initially consistent with a hematoma but was then diagnosed as a rhabdomyosarcoma upon clinical examination and ultrasonography at follow-up shortly after.
A 23-year-old male patient presented to our clinic with pain and limited motion in the right hip.... more A 23-year-old male patient presented to our clinic with pain and limited motion in the right hip. The pain start ed about 3 years previously and increased over time, spreading to the trochanteric region of the right hip and the right groin. The characteristic of the pain was mechanical. He did not feel pain while sleeping. Prolonged sitting or standing caused the hip to lock. Previously, he had received physical therapy and analgesic medications but there had been no significant improvement. There was no pain in any other joint, and there was no history of disease or trauma associated with the hip. Physical examination revealed an antalgic gait. Palpation of the iliopsoas muscle caused pain. The motion of the right hip joint was limited and painful in all directions, whereas lumbar and left hip joint motions were unrestricted and painless. There were no neurological deficits of the lower extremities. Radiography of the pelvis indicated a narrowing joint space, and there were erosion...
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