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The Covid-19 pandemic is a big challenge for all of us and has brought us suffering, death, and fear. This issue is an unprecedented situation and requires an unprecedented response. Fortunately, COVID-19 vaccines have been developed rapidly and in a short period, they were demonstrated to be safe and effective. Also, World Health Organization is working to promote fair access to safe and effective COVID-19 vaccines and coordinates key steps in this process. Nowadays, thankfully more than ten different vaccines have been administered. The vaccination programs started in early December 2020 and more than 20% of the world population has received at least one dose of a COVID-19 vaccine by the end of June 2021 (1,2). Some of the COVID-19 vaccines have been the first to be produced using the messenger RNA (mRNA) platform. While high effectivity is an expectation of these vaccines also, they are “reactogenic,” meaning that they’re likely to cause a noticeable immune response. So, according to reports, about side effects following vaccination with the Pfizer and Moderna mRNA vaccines the side effects of the COVID-19 vaccine vary with the type of the vaccine (3,4). While the soreness of the site of injection is the most common side effect, other side effects such as headache, fatigue, muscle aches, joint pain, chills, and fever usually last 24 to 48 hours (3,4). Maybe not as a side effect but, an imbalance was reported in the incidence of facial paralysis following the vaccination. Facial paralysis (FP) was reported during the phase 3 clinical trials of mRNA COVID-19 vaccines (3,4). Seven cases were observed in vaccine groups among the 35611 participants (3,4). Also, facial nerve-related disorders such as facial paresis, facial spasms, and nerve disorders were reported as a drug reaction with mRNA COVID-19 vaccines (5). According to reports, we see symptoms of nerve pathology can vary from one to another and range in severity from mild weakness to total paralysis (5). According to World Health Organization Pharmacovigilance Database, almost half of the patients with FP were reported from the United States of America (USA) and the United Kingdom (UK) (5). According to our current knowledge, there is no case reported from Turkey. In June 2021, we had the opportunity to treat two patients with FP who developed nerve damage following the Pfizer COVID-19 vaccine. The purpose of this letter is to describe the individual situation of two FP patients in detail and to help health professionals make a decision about how to do things in similar features., Covid-19 salgını hepimiz için büyük bir zorluk olmuş ve acı, ölüm ve korku getirmiştir. Günümüz için bu salgın eşi görülmemiş bir durumdur ve farklı bir yöntem gerektirir. Neyse ki, COVID-19 aşıları hızla ve kısa sürede geliştirildi, güvenli ve etkili oldukları gösterildi. Ayrıca, Dünya Sağlık Örgütü tüm ülkelerin, güvenli ve etkili COVID-19 aşılarına hakkaniyetli erişme imkanının sunulabilmesi için önerilerde bulunuyor ve bu süreçteki önemli adımları koordine ediyor. Günümüzde, onun üzerinde farklı Covid aşısı ruhsat aldı. Aşı programları Aralık 2020'nin başlarında başladı ve dünya nüfusunun ~ %20'sinden fazlası Haziran 2021 sonuna kadar en az bir doz COVID-19 aşısı aldı (1,2). COVID-19 aşılarından bazıları messenger RNA (mRNA) teknolojisi kullanılarak üretilen ilk aşılardır. Bu mRNA aşıları oldukça "reaktojenik"tir, yani belirgin bir bağışık yanıta neden olma olasılıkları yüksektir. COVID-19 aşısının yan etkileri aşının türüne göre değişkenlik gösterebilir (3,4). Pfizer ve Moderna mRNA aşısı uygulandıktan sonra, enjeksiyon bölgesinde ağrı (en yaygın yan etki), baş ağrısı, yorgunluk, kas ağrıları, eklem ağrısı, titreme ve ateş gibi yan etkiler genellikle 24 ila 48 saat sürer (3,4). Belki yan etki olarak değil ama aşılamadan sonra yüz felcinin görülme sıklığında bir farlılık olduğu bildirilmiştir. mRNA COVID-19 aşılarının faz 3 klinik çalışmaları sırasında yüz felci (YF) bildirilmiştir (3,4). 35611 katılımcı arasında aşı gruplarında yedi fasiyal paralizi olgusu gözlendiği bildirilmektedir. Ayrıca yüz parezisi, yüz spazmı, sinir bozuklukları gibi yüz siniri ile ilgili rahatsızlıklar mRNA COVID-19 aşıları ile ilaç reaksiyonu olarak bildirilmiştir (5). Sinir patolojisi semptomlarının kişiden kişiye değişebildiğini ve hafif zayıflıktan tam felce kadar değişkenlik gösterdiği bildirilmektedir (5). Dünya Sağlık Örgütü Farmakovijilans Veritabanı'na göre, YF'li hastaların neredeyse yarısı Amerika Birleşik Devletleri (ABD) ve Birleşik Krallık'tan (İngiltere) bildirilmiştir (5). Güncel bilgimize göre Türkiye'den bildirilen bir vaka bulunmamaktadır. Haziran 2021'de Pfizer COVID-19 aşısının ardından sinir hasarı gelişen YF'li iki hastayı tedavi ettik. Bu mektubun amacı, iki YF hastasının klinik özelliklerini ayrıntılı olarak tanımlamak ve sağlık profesyonellerinin benzer durumlarda süreç konusunda karar vermelerine yardımcı olmaktır.

AMAÇ; Bu çalışmanın amacı genç erişkin yaş grubunda el kavrama kuvveti (EKK) ile omuz (deltoid), sırt (trapez), kalça ekstansör (gluteus maksimus) ve fleksör (psoas majör) kasları ve diz ekstansör (kuadriseps) kas kuvvetleri arasındaki ilişkiyi ortaya koymaktır. GEREÇ VE YÖNTEM; Kesitsel araştırma niteliğinde yapılan ve 18-25 yaş aralığında 50 katılımcı ile tamamlanan bu çalışmada, el kavrama, pinch, omuz, sırt, kalça ve diz kas kuvveti ölçümleri dinamometre ile yapılmıştır. Her kas grubu için ölçüm 10 saniye arayla 3 kez uygulanmış ve ortalama değer “kg” birimi ile çalışmada kullanılmıştır. BULGULAR; Erkek katılımcıların kas kuvveti ölçümleri, kadın katılımcılara göre istatistiksel olarak daha fazlaydı (p

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.

Objective: Magnetic resonance imaging (MRI) is the gold standard examination in the evaluation of shoulder pathologies, but it is a static method, expensive and examination time is long. Ultrasonography (US) is a fast, easy-to-apply, cheap and common imaging method, but it is more subjective and dependent on experience. In this study, we aimed to compare the diagnostic accuracy of US with MRI in the diagnosis of shoulder joint pathologies, with increasing experience. Methods: A radiologist without sufficient shoulder US experience read the literature on shoulder US. Then, for 2 weeks, US was performed for training in 100 patients whose MRI findings were known. Subsequently, for 5 weeks, firstly US, then MRI were performed a total of 250 patients, including 50 patients every week. With increased US experience, it was investigated whether the consistency between US and MRI findings increased. Results: One hundred and sixty (64%) of the patients were female and 90 (36%) were male. The mean age of the patients was 54±11.7. Each week, patients were evaluated as a separate group, with a total of 5 groups. Sensitivity, specificity, positive and negative predictive values were calculated which were achieved with increasing US experience. Conclusion: When sufficient experience is gained in shoulder pathologies, diagnostic accuracy increases significantly in US. The success of US in partial tears is behind MRI. US lags behind MRI in showing joint effusion. The sensitivity and specificities in the subacromial-subdeltoid effusion are close to MRI. The rates of US to detect total tears, biceps tenosynovitis and acromioclavicular joint degeneration are similar to MRI. US is successful than MRI in showing calcific tendinitis, biceps subluxation-dislocation and impingement.

Şahin, Nilay (Balikesir Author), Objective: This study aimed to is to compare the pain levels, quality of life, and depression levels of geriatric patients and non-geriatric patients due to musculoskeletal pain. Materials and Methods: 300 GP and 250 NGP were included in this cross-sectional study. The inclusion criteria were as follows: patients aged between 18-90 years, those suffering from musculoskeletal pain, and those with a pain severity between 2 and 8 points agreed to participate in the study. Visual pain scale (VPS) was used for the assessment of pain severity. The quality of life was assessed by Short form-36 (SF-36). The Beck depression scale (BDS) was used to assess depression status. Results: In the GP group, the prevalence of additional comorbidities, frequency of drug use, and the number of painful sites in the musculoskeletal system were more frequent from those of the NGP group (p

To determine the efficacy of hippotherapy simulation exercise on the improvement of muscle strength, balance, spasticity, and quality of life in individuals with multiple sclerosis (MS).Randomized controlled trial.Outpatient clinic at the rehabilitation clinic of University of Usak, Turkey PARTICIPANTS: Individuals with MS (n = 40) participated in this randomized clinical study.Patients in both groups received 36 treatment sessions, 3 times per week for 12 consecutive weeks. Subjects in the study group performed hippotherapy simulation exercise via a hippotherapy simulator device. The control group received conventional home exercises.The primary outcome measures included the Monitoring My Multiple Sclerosis (MMMS) Scale, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test; quadriceps muscle strength was measured with a dynamometer.At the level of physical activity, post-intervention MMMS measures showed significant differences in both cases. TUG was significantly lower, and muscle strength and BBS were significantly higher in both post-interventions. No outcome measure showed a significant difference between the groups at both post-intervention and follow-up.The results of this study in the field of hippotherapy simulation exercise for people with MS indicate a positive effect on health conditions, balance, mobility skills, and muscle strength. Further studies are necessary to confirm these preliminary results.

Objectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale.

The aim of this study was to compare the fractal dimension (FD) of trabecular structure of the mandibular condyles in patients with rheumatoid arthritis (RA) to patients without RA. Correlations between condylar FD and bone mineral density T-scores in the femoral neck and lumbar spine were also examined.The RA study group patients were divided into 3 categories (33 normal, 33 osteopenic, and 34 osteoporotic) according to T-scores. The control group without RA was sex- and age-matched with the study group. FD was calculated from panoramic radiographs and compared between the study and control groups. The relationships between FD values and femoral neck and L1-L4 lumbar spine T-scores were investigated for study and control groups. Significance was established at P.05.The mean FD values of the entire study group and of each category in the study group were significantly lower than those of the control group (P.001). There were no significant differences in FD values among the 3 RA categories (P.05). No significant correlations appeared between FD and femoral neck or lumbar spine T-scores (P ≥ .063).Fractal analysis of the condyles on panoramic radiographs can distinguish RA from healthy condyles, even if the patients with RA have normal bone mineral density T-scores.

Introduction: Cerebral venous and sinus thrombosis (CVST) may lead to cerebral edema and increased intracranial pressure; besides, ischemic or hemorrhagic lesions may develop. Intracerebral hemorrhages occur in approximately one-third of CVST patients. We assessed and compared the findings of the cerebral hemorrhage (CH) group and the CVST group. Materials and Methods: In the VENOST study, medical records of 1,193 patients with CVST, aged over 18 years, were obtained from 35 national stroke centers. Demographic characteristics, clinical symptoms, signs at the admission, radiological findings, etiologic factors, acute and maintenance treatment, and outcome results were reported. The number of involved sinuses or veins, localizations of thrombus, and lesions on CT and MRI scans were recorded. Results: CH was detected in the brain imaging of 241 (21.1%) patients, as hemorrhagic infarction in 198 patients and intracerebral hemorrhage in 43 patients. Gynecologic causes comprised the largest percentage (41.7%) of etiology and risk factors in the CVST group. In the CH group, headache associated with other neurological symptoms was more frequent. These neurological symptoms were epileptic seizures (46.9%), nausea and/or vomiting (36.5%), altered consciousness (36.5%), and focal neurological deficits (33.6%). mRS was ≥3 in 23.1% of the patients in the CH group. Discussion and Conclusion: CVST, an important cause of stroke in the young, should be monitored closely if the patients have additional symptoms of headache, multiple sinus involvement, and CH. Older age and parenchymal lesion, either hemorrhagic infarction or intracerebral hemorrhage, imply poor outcome.

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).

Çalışmada 38 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.

Objectives: Headache is the most common complaint in cerebral venous sinus thrombosis (CVST) and it may sometimes bethe only symptom in these patients. This retrospective and prospective study was an investigation of any differences in termsof clinical risk factors, radiological findings, or prognosis in patients with CVST who presented with isolated headache (IH) andcases with other concomitant findings (non-isolated headache [NIH]).Methods: A total of 1144 patients from a multicenter study of cerebral venous sinus thrombosis (VENOST study) were enrolled inthis research. The demographic, biochemical, clinical, and radiological aspects of 287 IH cases and 857 NIH cases were compared.Results: There were twice as many women as men in the study group. In the IH group, when gender distribution was evaluated byage group, no statistically significant difference was found. The onset of headache was frequently subacute and chronic in the IHgroup, but an acute onset was more common in the NIH group. Other neurological findings were observed in 29% of the IH groupduring follow-up. A previous history of deep, cerebral, or other venous thromboembolism was less common in the IH group thanin the NIH group. Transverse sinus involvement was greater in the IH group, whereas sagittal sinus involvement was greater in theNIH group. The presence of a plasminogen activator inhibitor (PAI) mutation was significantly greater in the IH group.Conclusion: IH and CVST should be kept in mind if a patient has subacute or chronic headache. PAI, which has an importantrole in thrombolytic events, may be a risk factor in CVST. Detailed hematological investigations should be considered. Additional studies are needed. Amaç: Baş ağrısı serebral venöz sinüs trombozunda (SVST) en sık görülen şikayettir ve bazen CVST ile başvuran hastalarda görülen tek semptom olabilir. Bu retrospektif ve prospektif çalışmada, izole başağrısı (IB) ile başvuran SVST olgularında ve baş ağrısı ile ilişkili diğer bulguları olan (izole olmayan başağrısı-İOBA) olgularda klinik risk faktörleri, radyoloji ve prognoz açısından herhangi bir farklılık olup olmadığını araştırdık. Gereç ve Yöntem: Serebral venöz sinüs trombozu (VENOST) çok merkezli çalışmasından 1144 hasta çalışmamıza alındı. Tüm demografik, biyokimyasal, klinik ve radyolojik yönler 287 IBA vakası ve 857 İOBA vakası için karşılaştırılmıştır. Bulgular: Toplam grup içinde kadın oranı iki kat daha yüksekti. İBA grubunda cinsiyet dağılımını yaş gruplarına göre değerlendirildiğinde istatistiksel olarak anlamlı bir fark bulunmadı. İBA grubunda, baş ağrısının başlangıcı sıklıkla subakut ve kronikti, ancak akut başlangıç, İOBA grubunda daha yaygındı. İBA grubunda% 29’luk takip sırasında diğer nörolojik bulgular eklenmiştir. Daha önce serebral, derin ve diğer venöz tromboembolizm öyküsü İBA grubunda İOBA grubuna göre daha azdı. Transvers sinüs tutulumu İBA grubunda daha yüksek iken sagital sinüs tutulumu İOBA grubunda daha fazlaydı. Plazminojen aktivatör inhibitörü (PAI) mutasyonu IBA grubunda anlamlı olarak daha yüksekti. Sonuç: Hastaların subakut veya kronik baş ağrısı varsa SVST tanısı için IBA akılda tutulmalıdır. Trombolitik olaylar için önemli bir role sahip olan PAI, SVST’da bir risk faktörü olabilir, bu nedenle ayrıntılı hematolojik araştırmalar düşünülmelidir. Daha ileri çalışmalara ihtiyaç vardır WOS:000644197800002 2-s2.0-85105266958

Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

Amaç: Bu çalışmanın amacı, D vitamini eksikliği olan kadınlarda, cinsel işlevleri araştırmaktır. Gereç ve yöntemler: Vitamin D eksikliği saptanmış olan, 25-40 yaş aralığında 255 kadın, hasta grubu ve vitamin D seviyeleri normal aralıkta saptanan 255 kadın kontrol grubu olarak çalışmaya alındı. Her iki gruptaki katılımcılar cinsel yönden aktifti ve herhangi bir iletişim bozukluğu ya da zekâ geriliği yoktu. Seksüel fonksiyonlara etkisi olabilecek ürojinekolojik operasyon geçirenler, gebe veya emziren kadınlar, seksüel olarak aktif olmayan kadınlar, akut veya kronik hastalığı olanlar çalışma dışı bırakıldı. Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE) ve Kadın Seksüel Fonksiyon İndeksi (KSFİ) skorları belirlendi. Vitamin D seviyeleri serum 25 - hidroksi-vitamin D düzeyleri ölçülerek belirlendi. Bulgular: Hasta ve kontrol gruplarında yaş ve vücut kitle indeksi değerleri benzer idi (p> 0.05). D vitamini düzeyleri düşük kadınlarda BDE ve BAE skorlarının daha yüksek olduğu bulundu (p

PubMed ID: 29663478 Objective—To evaluate intraneural blood flow of the median nerve using superb microvascular imaging (SMI) and power Doppler ultrasonography (PDUS), and to examine their correlation with electroneuromyography in patients with carpal tunnel syndrome (CTS). Methods—A cross-sectional survey was used, and the study was conducted in the research unit of a training and research hospital. Patients diagnosed with CTS according to electroneuromyography studies were included in the study. Ultrasound measurements were taken using an Aplio-500 (Toshiba Medical System Corporation, Tokyo, Japan) device and a linear multifrequency 14-MHz probe. The cross-sectional area of the median nerve at the carpal tunnel level was measured by the direct tracing method using electronic calipers. The power Doppler ultrasonography and superb microvascular imaging scores were recorded by grading the vascularity between 0 and 3. Results—Evaluation was made of a total of 113 hands of 80 patients (18 men, 62 women) with a mean age of 34.67 ± 12.82 years. The mean duration of symptoms was 12.34 ± 6.66 months. When the patients were grouped as mild, moderate, and severe CTS, there was a statistically significant difference between the SMI and PDUS grades (P

Aim: We aimed to assess the incidence, mean size, patterns, and types of accessory and sesamoid bones of the foot using computed tomography. Material and Methods: A total of 814 non-contrast-enhanced computed tomography images of the foot obtained from 717 patients between October 2015 and January 2018 were investigated retrospectively. Images acquired in the original axial plane were used to perform multiplanar reconstruction in the coronal or sagittal planes. Incidence, mean size, patterns, and types of accessory and sesamoid bones were evaluated in all images. Results: Accessory bones were detected in 387 (47.5%) non-contrast-enhanced computed tomography scans from 326 patients (45.4%). Sixty-seven patients (9.3%) showed accessory bones on both sides; 133 patients (18.5%), only on the right side; and 126 patients (17.5%), only on the left side. The most common accessory bones of the foot were the os naviculare accessorium (24.8%), os trigonum, (20.3%), os peroneum (14.6%), os intermetatarseum (10.6%), os supranaviculare (3.1%), os supratalare (1.9%), and os vesalianum (1.5%). The hallucal sesamoid bone was observed in all patients, while the interphalangeal sesamoid bone was observed in 34.6% of the patients. Conclusions: The computed tomography scans provided a detailed overview of the characteristics of accessory and sesamoid bones, and the incidence of these bones in our patients was higher than those reported in previous radiographic studies. Our findings can facilitate the diagnosis and management of disorders involving these bones.

Objectives The aim of this study was to compare the diagnostic performance of different sonographic modalities for diagnosing lateral epicondylosis. Methods A total of 50 symptomatic and 50 asymptomatic common extensor tendons in 44 patients with lateral epicondylosis, and 25 healthy participants were prospectively examined by B-mode sonography, color Doppler imaging, power Doppler imaging, Superb Microvascular Imaging (SMI; Toshiba Medical Systems Corporation, Tokyo, Japan), and strain elastography. We evaluated blood flow in common extensor tendons by using a grading system with color Doppler imaging, power Doppler imaging, and SMI. The diagnostic performance of the modalities was compared. Results When a cutoff value of hypoechogenicity was used for the mean strain ratio, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rates were 92.0%, 94%.0, 93.9%, 92.2%, and 93.0%, respectively. When a cutoff point of grade 1 was used, the sensitivity, specificity, PPV, NPV, and accuracy rates were 26.0%, 10.0%, 10.0%, 57.5%, and 63.0, for color Doppler imaging; 40.0%, 10.0%, 10.0%, 62.5%, and 70.0% for power Doppler imaging; and 84.0%, 94.0%, 93.0%, 85.5%, and 89.0% for SMI. When a cutoff value of 3.94 was used for the mean strain ratio, the sensitivity, specificity, PPV, NPV, and accuracy rates were 78.0%, 92.0%, 90.7%, 80.7%, and 85.0%, respectively. A statistically significant correlation was detected between SMI, strain elastography, and visual analog scale scores (P

Carpal tunnel syndrome (CTS) is the most frequently diagnosed neuropathy of upper extremity entrapment neuropathies. We aimed to investigate the effectiveness of paraffin therapy in patients with CTS. Seventy patients diagnosed with mild or moderate CTS were randomly divided into two groups as splint treatment (during the night and day time as much as possible for 3 weeks) alone and splint (during the night and day time as much as possible for 3 weeks) + paraffin treatment (five consecutive days a week for 3 weeks). Clinical and electrophysiological assessments were performed before and 3 weeks after treatment. The patients were assessed by using visual analog scale (VAS) for pain, electroneuromyography (ENMG), and Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). The significant improvement was found in VAS scores in both groups when compared with pretreatment values (p 0.05). There was no significant improvement in functional capacity score (p 0.05), whereas a significant improvement was noted in the BCTQ symptom severity scale score in the splint group (p 0.05). Significant improvements were demonstrated in both scorers in the combined treatment group. Similarly, significant improvements were found in the combined treatment group in terms of motor and sensory distal latency, sensory amplitude, and median sensory nerve velocity (p 0.05). There was no significant change in electrophysiologic parameters in the splint group (p 0.05), and the difference in these parameters between the groups was statistically significant (p 0.05). In conclusion, using splinting alone in patients with CTS is an effective treatment for reducing symptoms in the early stages. Paraffin treatment with splint increases the recovery in functional and electrophysiological parameters.

Şahin, Nilay (Balikesir Author), [Purpose] The aim of this study is to compare patients with failed back surgery syndrome (FBSS) with those with non-specific chronic back pain (NSCBP) in terms of pain, depression, and quality of life levels to explain the effects of surgery experience on low-back pain. [Subjects and Methods] A total of 50 patients with FBSS and 51 patients with NSCBP who consecutively applied to the outpatient clinic from September 2012 to April 2013 were included in the study. Patients completed questionnaires on demographics, body mass index, education level, work history, and pain duration (in months). Lumbar pain at rest, during movement, and at night were measured with a visual analogue scale (VAS). The Short Form 36 scale was used for evaluating quality of life, and the Beck Depression Inventory (BDI) was used for assessing depression. [Results] VAS scores reporting pain at rest and at night and BDI scores were significantly higher in the FBSS group than in the NSCBP group. Role limitations due to physical functioning, which is one of the measures of quality of life, were significantly higher in the FBSS group than in the NSCBP group. [Conclusion] These assessments show that surgery experience in patients with ongoing low-back pain makes their pain and depression worse.

Letter to Editor, Comments on “Scientificity and H-Index.”..............................................................................................................Letter to Editor, Comments on “Scientificity and H-Index.”..............................................................................................................Letter to Editor, Comments on “Scientificity and H-Index.”.............................................................................................................., Editöre Mektup: Bilimsellik ve H-Endeksi hakkında yorum...................................................................................................................Editöre Mektup: Bilimsellik ve H-Endeksi hakkında yorum...................................................................................................................Editöre Mektup: Bilimsellik ve H-Endeksi hakkında yorum...................................................................................................................

OBJECTIVES: This study aims to evaluate and compare the short-term efficacies of high-intensity laser therapy (HILT) and low-intensity laser therapy (LILT) in the treatment of lateral epicondylitis (LE). PATIENTS AND METHODS: Sixty patients (16 males, 44 females; mean age 44.2±9.3 years; range, 18 to 65 years) with unilateral elbow pain were randomized into two groups as 30 patients treated with HILT (9 males and 21 females) and 30 patients treated with LILT (7 males and 23 females). The HILT (1,064 nm) and LILT (904 nm) were administered three times a week for three weeks, and each treatment was combined with an epicondylitis bandage. A visual analog scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (QDASH) questionnaire, Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36), and hand grip strength test were used to evaluate the patients before and three weeks after treatment. RESULTS: The two groups had similar demographic characteristics, including age, sex, occupation, and body mass index (p>0.05). There were no statistically significant differences between the two groups in terms of the pretreatment VAS, QDASH, hand grip strength, and SF-36 scores (p>0.05). After three weeks, both groups showed significant improvements in all of the parameters (p

WOS: 000465130500010, PubMed: 29992235, Objective This study was performed to determine the rate of cerebral venous sinus thrombosis (CVST) among cases of Behcet's disease (BD) included in a multicentre study of cerebral venous sinus thrombosis (VENOST). Methods VENOST was a retrospective and prospective national multicentre observational study that included 1144 patients with CVST. The patients were classified according to aetiologic factors, time of CVST symptom onset, sinus involvement, treatment approach and prognosis. Results BD was shown to be a causative factor of CVST in 108 (9.4%) of 1144 patients. The mean age of patients in the BD group was 35.27 years and 68.5% were men, whereas in the non-BD CVST group, the mean age was 40.57 years and 28.3% were men (P < 0.001). Among the aetiologic factors for patients aged 18-36 years, BD was predominant for men, and puerperium was predominant for women. The onset of symptoms in the BD group was consistent with the subacute form. The transverse sinuses were the most common sites of thrombosis, followed by the superior sagittal sinuses. The most common symptom was headache (96.2%), followed by visual field defects (38%). Conclusions BD was found in 9.4% of patients in our VENOST series. Patients with BD were younger and showed a male predominance. The functional outcome of CVST in patients with BD was good; only 12% of patients presenting with cranial nerve involvement and altered consciousness at the beginning had a poor outcome (modified Rankin Score 2).

Kozak, Hasan Huseyin/0000-0001-6904-8545; Sahin, Sevki/0000-0003-2016-9965; Batur Caglayan, Hale/0000-0002-3279-1842; GUNES, TASKIN/0000-0002-9343-0573; Afsar, Nazire/0000-0001-8123-8560; Uzuner, Nevzat/0000-0002-4961-4332 WOS: 000498868800011 PubMed: 31562041 Aim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings.

Sen, Ekin Ilke/0000-0002-6489-3368; karahan, ali yavuz/0000-0001-8142-913X; Akaltun, Mazlum Serdar/0000-0002-9666-9483, WOS: 000496659300007, Purpose Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Methods This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. the study included 1163 participants aged >= 65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity. Results the age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. the average total GUSS score was 18.57 +/- 1.41. the Cronbach's alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. the cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%. Conclusions the GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice. Key summary pointsAim We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Findings Total GUSS score sensitivity was 95.5% and its specificity was 94.4%. Message the GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older person who had no secondary dysphagia. It is suitable as a screen test for clinical practice.

Akaltun, Mazlum Serdar/0000-0002-9666-9483; Sen, Ekin Ilke/0000-0002-6489-3368; karahan, ali yavuz/0000-0001-8142-913X WOS: 000476771900010 Key summary pointsAimOur aim was to investigate which swallowing difficulty of food consistency in older people who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD) risk.FindingsWe have found that the eating/drinking difficulty of thick liquids was the highest predictive value with respect to OD risk and the eating difficulty of mixed content food had the highest diagnostic ratio.MessageThe present study reports that even in older person who do not go to the hospital with the complaints of swallowing difficulty, the difficulty of swallowing thick liquids and especially the mixed content food should be questioned. AbstractPurposeThe present study aimed to investigate which swallowing difficulty of food consistency in participants over 65years of age who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD).MethodsThe cross-sectional and multicenter study was conducted at 12 hospitals including 883 participants aged >= 65years who were fed orally and who were admitted to the physical medicine and rehabilitation outpatient clinics between September 2017 and December 2018. Demographic characteristics were recorded. Katz Daily Living Activities Index (KDLAI), swallowing-related quality of life scale (Swal-QoL) and 10-item Eating Assessment Tool (EAT-10) were used. The participants were asked the yes or no questions including swallowing difficulty of various types of food consistency with the face-to-face interview.ResultsParticipants were divided into two groups as normal swallowing (EAT-10= 3 group) (n=244) according to the EAT-10 scores. While there was no difference related to number of teeth and KDLAI scores between groups (p=0.327 and p=0.221, respectively), the significant difference was found between groups in terms of yes/no questions and Swal-QoL scores (p

The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and corticosteroid injection for the management of trigger finger. In this prospective randomized clinical trial, 40 patients with actively correctable trigger fingers were randomly assigned to extracorporeal shock wave therapy (1000 impulses and 2.1 bar) or injection groups. The effectiveness of the treatment was assessed using cure rates, a visual analogue scale, the frequency of triggering, the severity of triggering, the functional impact of triggering, and the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire at 1, 3, and 6 months after treatment. An intention-to- treat analysis was used in this study. Both groups demonstrated statistically significant improvements in all outcome measures after treatment. The intention-to-treat analyses showed no between-group differences for cure rates, pain, and functional status at follow-up. We conclude that extracorporeal shock wave therapy could be a non-invasive option for treating trigger finger, especially for those patients who wish to avoid steroid injections. Level of evidence: Level II.

Background: Osteoporosis is a widespread metabolic bone disease representing a global public health problem currently affecting more than two hundred million people worldwide. The World Health Organization states that dual-energy X-ray absorptiometry (DXA) is the best densitometric technique for assessing bone mineral density (BMD). DXA provides an accurate diagnosis of osteoporosis, a good estimation of fracture risk, and is a useful tool for monitoring patients undergoing treatment. Common mistakes in BMD testing can be divided into four principal categories: 1) indication errors, 2) lack of quality control and calibration, 3) analysis and interpretation errors, and 4) inappropriate acquisition techniques. The aim of this retrospective multicenter descriptive study is to identify the common errors in the application of the DXA technique in Turkey. Methods: All DXA scans performed during the observation period were included in the study if the measurements of both, the lumbar spine and proximal femur were recorded. Forearm measurement, total body measurements, and measurements performed on children were excluded. Each examination was surveyed by 30 consultants from 20 different centers each informed and trained in the principles of and the standards for DXA scanning before the study. Results: A total of 3,212 DXA scan results from 20 different centers in 15 different Turkish cities were collected. The percentage of the discovered erroneous measurements varied from 10.5% to 65.5% in the lumbar spine and from 21.3% to 74.2% in the proximal femur. The overall error rate was found to be 31.8% (n = 1021) for the lumbar spine and 49.0% (n = 1576) for the proximal femur. Conclusion: In Turkey, DXA measurements of BMD have been in use for over 20 years, and examination processes continue to improve. There is no educational standard for operator training, and a lack of knowledge can lead to significant errors in the acquisition, analysis, and interpretation.

The aim of this study was to define attitudes toward ageism among nursing and geriatric care students at two schools. Fifty students from the Sick and Elder Care School (SECS) and the Nursing Servi...

Ibandronic acid (IA) is a potent bisphosphonate drug used in the prevention and treatment of osteoporosis. It may also be used to treat hypercalcemia (elevated blood calcium levels). Arthralgia, femur fracture, pain in extremity, diarrhea, myalgia, nausea, back pain, pain, and bone pain are most common adverse events of the IA reported to the FDA. We discourse a case of IA extravasation in this presentation. An osteoporotic woman who was using bifosfonate medications had applied intravenous IA, but almost all of the solution was extravasated accidentally. Two hours later she noticed burning and moderate itching sensation and slight millimeter erythema at the flexure of the right elbow in the region of venipuncture but she had decided not to inform. Although the day after the erythematous area had increased to 5-6 cm and the symptoms worsened, she revisited the outcome clinic. Also, she had a complaint of vomiting and diarrhea. Also, we want to discuss the question of “How this patient's osteoporosis treatment should be continued after this situation?”

PubMed ID: 29627888 We aimed to compare the efficacy of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) in the treatment of plantar fasciitis (PF). Seventy patients were randomized into either the LLLT (8 men, 27 women; mean age 48.65 ± 10.81 years) or HILT (7 men, 28 women; mean age 48.73 ± 11.41 years) groups. LLLT (904 nm) and HILT (1064 nm) were performed three times per week, over a period of 3 weeks. Each treatment combined with silicone insole and stretching exercises. Patients’ pain and functional status were evaluated with Visual Analog Scale, Heel Tenderness Index, and Foot and Ankle Outcome Score before and after treatment. A chi-square test was performed to compare demographic and clinical characteristics. Within-group and between-group differences were also investigated. Paired samples t test was used to analyze the differences between baseline and after treatment values, while independent samples t test was used to compare the two groups. Both groups contained similar demographic characteristics including age, sex, and body mass index (all p > 0.05). Three and two patients in the HILT and LLLT group, respectively, were lost to follow-up. At the study onset, there were no statistically significant differences between the two groups in the Visual Analog Scale, Heel Tenderness Index, and Foot And Ankle Outcome Scores. Three weeks later, both groups showed significant improvement in all parameters (p < 0.05). The HILT group demonstrated better improvement in all parameters than the LLLT group. Although both treatments improved the pain levels, function, and quality of life in patients with PF, HILT had a more significant effect than LLLT. © 2018, Springer-Verlag London Ltd., part of Springer Nature.

WOS: 000429653400007, PubMed: 31453489, Objectives: This study aims to investigate the effect of physical therapy modalities on pain and functional status in patients with non-specific low back pain. Patients and methods: Between February 2011 and August 2013, a total of 104 patients (38 males, 66 females; mean age 49.3 +/- 12.5 years; range 34 to 62 years) with non-specific chronic low back pain for more than 12 weeks without any neurological deficit were included in this randomized-controlled study. The patients were divided into two groups: physical therapy group (n=52) and control group (n=52). Both groups were given exercise and medical treatment; physiotherapy modalities were also applied in the physical therapy group. The patients were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Istanbul Low Back Pain Disability Index (ILBP) before treatment and at two weeks, three months, and one year after treatment. Results: A total of 100 patients completed one-year follow-up. In both groups, the VAS, ODI, and ILBP significantly improved after treatment (p