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Purpose: Shoulder arthroplasties are increasingly performed, but data on periprosthetic joint infections (PJI) in this anatomical position are limited. We retrospectively investigated the characteristics and outcome of shoulder PJI after primary arthroplasty from 1998 to 2010 in a single centre. Methods: Periprosthetic joint infection was defined as periprosthetic purulence, presence of sinus tract or microbial growth. A Kaplan-Meier survival method was used to estimate relapse-free survival of prosthesis. Results: From 1,571 primary shoulder prostheses, we evaluated 16 patients with a PJI at different stages, i.e, early (n=4), delayed (n=6) and late (n=6) infections. The median patient age was 67 (range 53-86) years, and 69% were females. The most commonly isolated microorganism was Propionibacterium acnes in 38% of patients (monobacterial in four and polymicrobial in two patients). In 14 of the 16 patients, surgical interventions consisting of debridement and implant retention (6 patients), exchange (7) and explantation (1) were performed. Four patients had a relapse of infection with P. acnes (n=3) or Bacteroides fragilis (n=1). The relapse-free survival of the prosthesis was 75% (95% confidence interval 46-90%) after 1 and 2years, 100% in six patients following the treatment algorithm for hip and knee PJI and 60% in 10 patients not followed up. All but one of the relapses were previously treated without exchange of the prosthesis. Conclusions: As recommended for hip and knee PJI, we suggest treating shoulder PJI with a low-grade infection by microorganisms such as P. acnes with an exchange of the prosthesis. Cohort studies are needed to verify our results

BACKGROUND: In treatment of adhesive capsulitis, deep heating agents have been shown to have positive effects on pain and function.

BACKGROUND: In treatment of adhesive capsulitis, deep heating agents have been shown to have positive effects on pain and function. OBJECTIVE: To evaluate if addition of ultrasound used in treatment of adhesive capsulitis will provide additional benefits. METHODS: Thirty patients with adhesive capsulitis were included in a prospective, double-blind, randomized controlled trial. Hotpack, TENS (Transcutaneus Electrical Nerve Stimulation), exercise and active ultrasound therapies were applied to the first group (n= 15), whereas sham ultrasound was applied to the second group (n= 15) in addition to hotpack, TENS and exercise. The patients were evaluated using joint range of motion, UCLA shoulder scale and Shoulder Disability Questionnaire scales at baseline and at 6th and 24th weeks post-treatment. RESULTS: When pain and the clinical and functional parameters were compared in both groups, significant improvement was found compared to baseline (p< 0.001). At week 24, no difference was found in terms of pain at rest, but all other parameters were improved compared to week 6. When the groups were compared, no difference was found in any comparison between 6th and 24th week (p> 0.05). CONCLUSION: Adding ultrasound treatment to a combination of physical therapy modalities did not provide any additional benefits for the treatment of adhesive capsulitis.

BACKGROUND: Clinical and electrophysiological effects of therapeutic ultrasound (US) were researched in many studies on patients with CTS with conflicting results.

9th International Eurasian Hematology Oncology Congress (EHOC) -- OCT 17-20, 2018 -- Istanbul, TURKEY, Sahin, Fahri/0000-0001-9315-8891; Saydam, Guray/0000-0001-8646-1673, WOS:000447176600099, [No Abstract Available]

9th International Eurasian Hematology Oncology Congress (EHOC) -- OCT 17-20, 2018 -- Istanbul, TURKEY, Saydam, Guray/0000-0001-8646-1673; Sahin, Fahri/0000-0001-9315-8891, WOS:000447176600138, [No Abstract Available]

9th International Eurasian Hematology Oncology Congress (EHOC) -- OCT 17-20, 2018 -- Istanbul, TURKEY, /0000-0003-3636-6082; Sahin, Fahri/0000-0001-9315-8891; kaymaz, burcin tezcanli/0000-0003-1832-1454; Saydam, Guray/0000-0001-8646-1673, WOS:000447176600063, [No Abstract Available]

Objectives: To analyze the relationship between vertebral fracture, degree of kyphosis, and BMD in women living in nursing homes. Methods: This cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation, Hitit University Hospital, Corum, Turkey, between January 2014 and January 2015. Of the 126 female patients who participated in the study, 48 lived in nursing homes (nursing-home-group [NHG]), 78 lived in non-nursing home settings (control-group [CG]). Vertebral fractures were evaluated via the semi-quantitative Genant method. Cases in which a Cobb angle measured 40 degrees or more resulted in a diagnosis of kyphosis. Results: The mean age of participants in the NHG was 77.2 +/- 7.6 years and 76.8 +/- 6.2 years in the CG (p>0.05). The kyphosis rate in the NHG was found to be higher at 52.1% compared to 27.7% for the CG (p0.05). The Cobb angle had correlation with the number of fractures in both groups (p

We aim to draw attention to occult, atraumatic fractures of the odontoid process in patients with rheumatoid arthritis (RA) and to underline difficulties encountered during clinical and radiological diagnosis. A forty-seven years old man with RA for 4 years had occipital pain for 1 year without any history of trauma. Later, he developed weakness in the upper extremities, but he did not realize weakness in the lower extremities due to deformities. Contrast magnetic resonance imaging revealed a linear fracture of odontiod process and myelopathy. Cervical computed tomography scan revealed an old fracture border with separated and almost disappeared remnant of the tip of the odontoid without free particles in the cord. It was impossible to evaluate atlantoaxial and vertical subluxations with craniometric measurements due to destruction of the tip of odontoid. Following occipitocervical fusion and decompression and a rehabilitation program, his muscle strength improved; however, functional myelopathy stage did not change. Atraumatic fractures of the odontoid process may be more common than reported and may cause compression of the spinal cord or brain stem. Surgery is the treatment of choice but functional recovery is limited once neuronal damage has occurred. Erosion of the critical landmarks makes it difficult to diagnose and follow up atlantoaxial subluxation and/or vertical subluxation, therefore clinicians should consider radiographical follow-ups during the course of the disease.

Objective: To investigate the factors that affect disability and quality of life in patients with spinal cord injuries (SCIs) and to compare the degree of disability and quality of life in patients with SCI according to over and under 18 years of age when their injury occurred. Design: Cohort study. Setting: Two academic hospitals in Istanbul, Turkey. Participants: Forty patients with SCI were included in this study. Group 1 included 20 patients with SCI who were younger than 18 years of age when their injury occurred, Group 2 included 20 patients who were older than 18 years of age when their injury occurred. Outcome Measures: Patients' demographics, duration of SCI and degree of disability were assessed using the Craig Handicap Assessment and Reporting Technique (CHART). Quality of life was assessed using the World Health Organization Quality of Life Scale Short Form (WHOQOL-Bref). Depression was assessed using the Beck Depression Inventory (BDI). Results: Although there was no significant difference between the BDI scores and CHART scores of the two groups, environment domain scores in the WHOQOL-Bref were significantly higher in Group 2 than in Group 1 (P

Objective: To determine the prevalence of restless legs syndrome (RLS) in patients with chronic renal failure (CRF) and to compare CRF patients with or without RLS in terms fatigue and sleep quality. Methods: A cross-sectional study was conducted on 220 patients (18-75 years) who were undergoing dialysis 3 times weekly in Corum Province, Corum, Turkey, between January 2014 and January 2016. The diagnosis of RLS was based on the diagnostic form proposed by the international RLS study group. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and severity of fatigue was determined by using fatigue severity scale (FSS). Results: Of all the participants, 16.8% (n=37) (Group 1) were found to have RLS, while 183 patients had no RLS (Group 2). The mean ages were similar between groups. With respect to laboratory analyses, a p-value of

WOS: 000423774100235

BACKGROUND: Although there are several studies of Transcutaneous Electrical Nerve Stimulation (TENS) and exercise in myofascial pain syndrome, there are no studies comparing the effectiveness of Kinesio Taping (KT) and TENS in myofascial pain syndrome patients.

BACKGROUND: Although there are several studies of Transcutaneous Electrical Nerve Stimulation (TENS) and exercise in myofascial pain syndrome, there are no studies comparing the effectiveness of Kinesio Taping (KT) and TENS in myofascial pain syndrome patients. OBJECTIVE: To compare the early and late effects of TENS and KT on pain, disability and range of motion in myofascial pain syndrome patients. METHODS: Sixty-nine patients were divided into three groups randomly as TENS+Exercise, KT+Exercise and exercise groups. Visual Analogue Scale (VAS), pain threshold, Neck Disability Index and cervical contralateral lateral flexion were employed in the evaluation of the patients performed before treatment, after treatment and 3rd month after treatment. RESULTS: The VAS, pain threshold, Neck Disability Index and contralateral lateral flexion values were improved in all groups both in after treatment and 3rd month after treatment (p< 0.01). In the comparison of after treatment vs. before treatment evaluations, VAS score was decreased in KT group compared to the TENS and control group (p= 0.001), in the TENS group compared to control group (p= 0.011). In the comparison of 3rd month and before treatment evaluations, VAS score was decreased in the TENS group compared to control group (p= 0.001) and in the KT group compared to the control group (p= 0.001). There was no significant difference between TENS and KT groups. All other parameters did not differ between the groups. CONCLUSIONS: TENS and KT added exercises can decrease pain severity and increase pain threshold, function and cervical range of motion in myofascial pain syndrome patients. Addition of TENS or KT to the exercise therapy resulted in more significant improvement compared to exercise therapy alone with a more pronounced improvement in KT group compared to the TENS group in the early period. Because KT was found to be more effective in decreasing the pain and had the advantage of being used in every 3 days, it seems to be beneficial in acute painful periods in myofascial pain syndrome patients.

22nd Congress of the European-Hematology-Association -- JUN 22-25, 2017 -- Madrid, SPAIN, WOS: 000404127005030, European Hematol Assoc

BACKGROUND: Although functional results of combined rehabilitation programs are reported, there have been no reports studying the effects of solo pendulum exercises on ultrasonographic measurements of acromiohumeral distance (AHD).

BACKGROUND: Although functional results of combined rehabilitation programs are reported, there have been no reports studying the effects of solo pendulum exercises on ultrasonographic measurements of acromiohumeral distance (AHD). OBJECTIVE: To investigate the effects of weighted and un-weighted pendulum exercises on ultrasonographic AHD and clinical symptoms in patients with subacromial impingement syndrome. METHODS: Patients with subacromial impingement syndrome were randomized to performing weighted (1.5 kilograms hand held dumbbell, N= 18) or un-weighted (free of weight, N= 16) pendulum exercises for 4 weeks, 3 sessions/day. Exercises were repeated for each direction of shoulder motion in each session (ten minutes). Clinical situation was evaluated by Constant score and Shoulder Pain Disability Index (SPADI). Ultrasonographic measurements of AHD at 0°, 30° and 60° shoulder abduction were performed. All clinical and ultrasonographic evaluations were performed at the beginning of the exercise program and at end of 4 weeks of exercise program. RESULTS: Thirty-four patients (23 females, 11 males; mean age 41.7 ± 8.9 years) were evaluated. Significant clinical improvements were detected in both exercise groups between pre and post-treatment evaluations (p < 0.05). There was no significant difference for pre and post-treatment AHD measurements at 0°, 30°, and 60° shoulder abduction between groups (p > 0.05). There was no significant difference for pre and post-treatment narrowing of AHD (narrowing of 0°-30°, and 0°-60°) between groups (p > 0.05). CONCLUSION: While significant clinical improvements were achieved with both weighted and un-weighted solo pendulum exercises, no significant difference was detected for ultrasonographic AHD measurements between exercise groups.

This article presents a preliminary comparative stratigraphy of excavated sites in Plain Cilicia and one in Rough Cilicia. It is the outcome of three workshops held in 2014, 2015 and 2017. Plain Cilicia at the junction of Anatolia, Syro-Mesopotamia and Cyprus is one of the most fertile regions of the Ancient Near East. In recent years, archaeological research in the region has intensified, re-opening questions of chronology. The comparative stratigraphy discussed in the workshops is presented here in form of a gazetteer of the participating sites and a chart. This is to be understood as a first step towards a more comprehensive chronology.

BACKGROUND: Shoulder pain is frequently observed in haemodialysis patients.

Objective: Radiology information system (RIS) is basically evolved for the need of radiologists and ignores the vital steps needed for a proper work flow of Nuclear Medicine Department. Moreover, CT/MRI oriented classical PACS systems are far from satisfying Nuclear Physicians like storing dynamic data for reprocessing and quantitative analysis of colored images. Our purpose was to develop a workflow based Nuclear Medicine Information System (NMIS) that fulfills the needs of Nuclear Medicine Department and its integration to hospital PACS system. Material and Methods: Workflow in NMIS uses HL7 (health level seven) and steps include, patient scheduling and retrieving information from HIS (hospital information system), radiopharmacy, acquisition, digital reporting and approval of the reports using Nuclear Medicine specific diagnostic codes. Images and dynamic data from cameras of are sent to and retrieved from PACS system (Corttex©) for reprocessing and quantitative analysis. Results: NMIS has additional functions to the RIS such as radiopharmaceutical management program which includes stock recording of both radioactive and non-radioactive substances, calculation of the radiopharmaceutical dose for individual patient according to body weight and maximum permissible activity, and calculation of radioactivity left per unit volume for each radionuclide according their half lives. Patient scheduling and gamma camera patient work list settings were arranged according to specific Nuclear Medicine procedures. Nuclear Medicine images and reports can be retrieved and viewed from HIS. Conclusion: NMIS provides functionality to standard RIS and PACS system according to the needs of Nuclear Medicine. Conflict of interest:None declared.

Objectives: This study aims to investigate the effect of additional trunk exercises to conventional exercise program on balance, functional condition and ambulation in early stage stroke patients. Patients and methods: A total of 65 patients were included in this double-blinded randomized controlled study. Patients were assigned to two groups as experimental group (n=32) who performed trunk exercises two hours/day/three weeks accompanied by conventional exercise program, and control group (n=32) who received only conventional exercise program during the three weeks. Balance, trunk balance, functional level and ambulation were assessed by Berg Balance Scale, Trunk Impairment Scale, Functional Independence Measurement, Rivermead Mobility Index, respectively. Patients were evaluated pretreatment and on the third month after the treatment. Results: There was no statistically significant difference between the outcome measurements between the groups at the pretreatment evaluation. All outcome measurements were improved significantly between pre- and post-treatment evaluation in general linear repeated measures model. The interaction parameter of "time x condition" according to time and recovery was significantly better in experimental group than in control group. The highest mean difference in efficacy between the two rehabilitation interventions was found for dynamic sitting balance in post hoc calculations. Conclusion: According to the results of our study, in early stroke patients either conventional exercises or conventional exercises plus trunk balance exercises can provide significant improvement in balance, functional condition and ambulation. However, the level of the improvement is better for the group which was applied trunk balance exercises to conventional exercises. Trunk balance exercises that are easily applicable with simple mechanisms by the patients themselves can be added to the rehabilitation.

In this study, a single-cylinder, four-stroke, single overhead camshaft (SOHC), spark ignition (SI) gasoline engine was converted to run with liquefied petroleum gas (LPG) fuel. To improve the volumetric efficiency, the camshaft of the engine was re-designed using classical spline method for different valve lifts. The variations of engine brake torque, power, brake specific fuel consumption (BSFC), HC, CO, CO2 and NOx emissions and exhaust gas temperature were investigated with unleaded gasoline and LPG fuels for different valve lifts. The experiments were conducted at 1700-3200 rpm engine speeds range at wide open throttle (WOT) and lambda = 1. Engine torque and power decreased and BSFC increased with LPG fuel for the 7 mm valve lift. Brake engine torque decreased by 8.82% and BSFC increased by 7.25% with LPG fuel compared to gasoline for 7 mm valve lift at 2600 rpm engine speed. However, HC and CO emissions decreased, NOx emissions increased with the usage of LPG fuel. HC and CO emissions decreased by 18.24% and 5.3%, respectively, and NOx emissions increased by 7.67%, with LPG fuel at 2600 rpm engine speed. An improvement was observed on engine torque, BSFC, HC and CO emissions with the increase of the valve lift to 8 mm and LPG fuel. At the low engine speeds, engine performance and exhaust emissions deteriorated with the increase of valve lift for gasoline fuel, while improvements were found at middle and higher engine speeds. (C) 2016 Elsevier Ltd. All rights reserved.

We aimed to determine the incidence of osteoporosis in hemodialysis patients, to evaluate the differences due to arteriovenous fistula on bone mineral density (BMD) and to investigate whether usage of arm with fistula has an effect on BMD. In this cross-sectional study, 96 patients with chronic renal disease undergone to dialysis were included. Place of fistula (radial and brachial) and dominant hand were recorded. All patients were asked to complete Likert's scale in order to determine the frequency of their usage of arm with fistula. Patients were assigned in two groups: age >51 and < 50years. Age-matched control group included 60 subjects. BMD measurements were done on lumbar vertebra, femur and both forearms. BMD measurement of proximal femur and total radius were significantly lower in patients >50years compared to healthy controls and bone density measurement of lumbar vertebra, proximal femur, 1/3 distal and total radius were significantly lower in patients < 50years compared to healthy controls (p < 0.05). BMD measurement was significantly lower in arms with fistula, especially with radial fistula, compared to both arms without fistula and healthy controls (p < 0.05). When all patients were evaluated, BMD scores were lowering by increasing age, duration of dialysis and fistula and decreasing usage of arm with fistula. BMD in hemodialysis patients is lower than normal population. BMD of arm with fistula is lower than arm without fistula and healthy controls. Both radial and brachial fistula affect negatively ipsilateral BMD. Movement of arm with fistula has positive effects on BMD.

Phosphatidylinositol 3-kinases (PI3Ks) are considered as lipid kinases that are very active in the pathobiology of lymphoproliferative disorders (LPDs). Idelalisib, a selective inhibitor of the delta isoform of PI3K, provides significant clinical efficacy and has an acceptable side-effect profile in the treatment of B-LPDs. The aim of this review is to outline the pharmacobiological basis of idelalisib that is located at the crossroads of B-LPDs. The PI3K signaling pathway with downstream targets including Akt is involved in hematologic malignancies and lymphomas. Idelalisib has been most widely studied in chronic lymphoid leukemia (CLL) and B-lymphoma. The activity of idelalisib in high-risk FL with early relapse following front line immunochemotherapy was recently shown. The unique immunological toxicity pattern of idelalisib was also decribed in this review. Further clinical investigations will help for the better selection of the subsets of the patients with B-LPD that would be best candidates for the clinical utilization of idelalisib. Other indications such as marginal zone lymphoma, mantle cell lymphoma, Waldenstrom’s Macroglobulinemia and other B-cell disorders could likely to be expanded. Future clinical and experimental data combined with the next-generation genomics strategies and personalized medicine for the treatment of malignant disorders will enlightened us for better placement of idelalisib in the treatment algorithm of the patients. © 2016, UHOD - Uluslararasi Hematoloji Onkoloji Dergisi. All rights reserved.

Objective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of >= 60 years old who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment. Median overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of = 5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA.

Mediastinal tuberculous lymphadenitis is a rare disease in adults. Dysphagia as the accompanying symptom is even a rarer manifestation. Cases with esophageal symptoms may present as esophageal ulceration, mucosal or submucosal mass, fistula or sinus formation, extrinsic compression or displacement of the esophagus. Extrinsic compression may radiologically or endoscopically present as a submucosal tumor. Our case is a 30-year-old woman with dysphagia for a month. Extrinsic compression was seen endoscopically on the mid-esophagus. On thoracic CT and MRI images, a multiloculated cystic/necrotic mass 5.5×4.8×3.1 cm in size consisting of multiple septa was located subcarinally in the middle mediastinum. In Wang needle aspiration, a mucopurulaent liquid was aspirated from the subcarinal localization by bronchoscopy. Diagnostic thoracotomy was carried out because histological and bacteriological examinations were not diagnostic. It was reported as tuberculous lymphadenitis pathologically. The control thoracic CT performed after antituberculous treatment showed complete regression of the mass. We herein report a rare form of tuberculous lymphadenitis.

20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRIA, WOS: 000361204903071

20th Congress of European-Hematology-Association -- JUN 11-14, 2015 -- Vienna, AUSTRIA, WOS: 000361204902433