Effectiveness of dry needling in the treatment of neck pain and disability associated with myofascial trigger points

Objective: The aim of this study is to evaluate the effectiveness of dry needling (DN) with fast-in and fast-out technique for myofascial trigger points (MTrPs) in the upper trapezius muscle associated with neck pain. Patients and Methods: Patients aged 18-70 years, who have had neck pain at least one active MTrP in the upper trapezius muscle treated with DN, were included in the study. Pain and disability were assessed with Numeric Rating Scale (NRS) and Neck Disability Index (NDI) before treatment (T0), after first session (T1) and after last session (T2). Number of MTrPs where DN was performed and the number of DN sessions were recorded. Patients were evaluated based on the minimal clinically important change (MCIC) scores for NRS and NDI. Results: A total of 76 patients (Female: 67, Male: 9) were included in the study. Median number of DN sessions was 3 and median of MTrPs that DN performed was 4. Both NRS and NM showed significant improvement at T1 and T2. More than 90% of patients had MCIC at T1 and T2. Conclusion: Dry needling with fast-in and fast-out technique is effective for pain and disability management in patients with neck pain due to MTrPs

Assessment of the factors affecting the loss of workforce in patients with traumatic hand injury

Objective: This study aimed to examine the factors affecting the loss of workforce, including the time to return to work and workrelated situations in patients with traumatic hand injury who were taken to a hand rehabilitation program

Effect of hand dominance on functional outcomes in paediatric patients with flexor tendon injuries: A cross-sectional study

Introduction There are limited data in the literature about the short- to mid-term results of children with flexor tendon injuries. We aim to evaluate the short- to mid-term functional outcomes of children with flexor tendon injuries and to disclose whether the injured side affects the results. Materials and methods Patients who had undergone primary flexor tendon repair were included in the study. The demographic and clinical characteristics of the patients were recorded. Modified Hand Injury Severity Score was calculated for each patient. Sensory, motor and functional assessments of the bilateral hand were performed. Results A total of 44 patients (female = 16, male = 28) with a median age of 13 (6-17) were evaluated. Significant differences between the affected and healthy hands of the patients in terms of grip and pinch strengths and monofilament sensory test results were demonstrated while the Jebson Taylor Hand Function Test (JTHFT) scores were similar. No factor other than the injury side was found to be related to the affected hand functions. In patients with dominant hand injuries, JTHFT results of the affected hands were similar to the results of healthy dominant hands (P = .935). However, JTHFT results were found to be worse in the affected non-dominant hands compared to healthy non-dominant hands (P = .01). Conclusion This study demonstrated that paediatric population with flexor tendon injuries in their dominant hands has better short- to mid-term functional outcomes. These results may be attributed to use their injured dominant hand more actively in daily activities

Ultrasound guided steroid injection of subacromial bursa: morphologic and clinical effects on patients with supraspinatus tendon calcifications

Objective: Subacromial injection (SAI), due to its ease of application and increased patient tolerability, is one of the preferred invasive therapies. In this study, we aimed to evaluate effectiveness of ultrasound-guided SA I in patients with supraspinatus calcific tendinitis by assessment of roentgenograms and clinical appraisal. Patients and Methods: Thirty-five patients with supraspinatus tendon calcifications as revealed by the roentgenography underwent ultrasound-guided SAL Pre-treatment the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) scores and Gartner's aassification of calcific tendinitis were obtained. Clinical follow-up was scheduled at 1st, 3rd and 6th months post-treatment along with a single roentgenogram planned at 6th month. Results: A total of 53 SAIs were performed on 36 shoulders, 21 female and 14 male patients. Mean size of calcifications were 12.3 and 7.1 mm, pre-treatment and at 6th month, respectively. Pre and post-injection calcification mean sizes in the group with clinical improvement were 13.6 and 5.7 mm; whereas, in group without diminished symptoms, they were 11.8 and 9.4 mm demonstrating a statistically significant intergroup difference (p<0.05). Pre-injection QuickDASH mean score was 52.2; this showed improvement at 1st, 3rd and 6th months post-treatment; 20.7, 22.2 and 193, respectively. Conclusion: Subacromial injection is a well-tolerated, easily applicable, safe and effective treatment for pain alleviation in supraspinatus calcific tendinitis

Soft tissue sarcoma of the upper extremity: oncological and functional results after surgery

This retrospective study evaluates outcomes after treatment of upper-extremity soft tissue sarcoma in 44 patients. We re-resected 19 tumours that had been resected elsewhere without adequate preoperative planning, and we made 25 well-planned primary resections. Four patients in the unplanned group and five in the planned group eventually received amputations. Thirty-three patients were alive at a median follow-up time of 33 months (IQR 18 to 57). Tumour size > 7 cm, tumour Grade 3 and the presence of distant organ metastases were the main factors affecting the oncological outcomes. We found no statistical differences between the planning groups. Functional outcomes and quality of life were significantly worse after amputation or major nerve resections. We conclude with this sized sample that the lack of planning in itself did not influence the final results, but there were differences in tumour size, grade and localization between the groups that may play a role

Staphylococcus aureus costochondritis and chest wall abscess in a COVID-19 patient treated with tocilizumab

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, causing a global health threat. Up to 15% of the confirmed cases develop severe disease, requiring hospitalization or intensive care unit (ICU) admission. Tocilizumab, an IL-6 receptor antagonist, is a promising treatment of severe pneumonia with acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) in the course of COVID-19. We report a suppurative costochondritis and chest wall abscess in a severe COVID-19 patient treated with tocilizumab

The validity and reliability of Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) in a Turkish population

Background Systemic lupus erythematosus (SLE) may have a profound impact on quality of life. There is increasing interest in measuring quality of life in lupus patients. The purpose of this study was to investigate the validity and reliability of SLE Quality of Life Questionnaire (L-QoL) in Turkish SLE patients. Methods SLE according to 2012 Systemic Lupus International Collaborating Clinics Classification Criteria were recruited into the study. Demographic data, clinical parameters and disease activity measured with the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K); were noted. Nottingham Health Profile and Health Assessment Questionnaire were filled out in addition to the Turkish L-QoL (LQoL-TR). Internal consistency, test-retest reliability, and convergent and discriminant validity were evaluated. Results The mean age of participants was 43.5514.33 years and the mean disease duration was 89.8 +/- 92.1 months. The patients filled out LQoL-TR in 2.5min. Strong correlation of LQoL-TR with all subgroups of the Nottingham Health Profile and the Health Assessment Questionnaire were established showing the convergent validity. The highest correlation was demonstrated with emotional reactions (rho=0.72) and sleep component (rho=0.65) of the Nottingham Health Profile scale (p<0.0001). Its poor and not significant correlation with nonfunctional parameters (age, disease duration, perceived general health, SLEDAI-2K) showed its discriminative properties. LQoL-TR demonstrated good internal reliability with a Cronbach's of 0.93 and test-retest reliability with intraclass correlation coefficient of 0.87. Conclusion The LQoL-TR is a practical and useful tool which demonstrates good validity and reliability

The evaluation of the static and dynamic balance disorders in patients with psoriatic arthritis

To evaluate the static and dynamic balances in psoriatic arthritis (PsA) and to investigate their relationship with clinical and functional parameters. Patients diagnosed with PsA and healthy controls were recruited consecutively into the study. The demographic variables such as age, sex, body mass index of the subjects were noted. Radiographic images were examined for the detection of foot deformities. Foot and Ankle Outcome Score' (FAOS) was used to assess foot function. The dynamic and static balance of the patients was evaluated by Berg Balance Scale' (BBS) and Neurocom Balance Master' device. The fatigue (Multidimensional Assessment of Fatigue: MAF), depression (Beck Depression Inventory: BDI) and sleep disorders (Pittsburgh Sleep Quality Index: PSQI) of all patients were evaluated. This study included 50 PsA patients and 50 healthy controls with mean ages of 45.02 (SD 12.81) and 45.12 (SD 10.56), respectively. Demographic data of both groups were similar. Concerning the balance tests, there were significant differences (p<0.05) between patient and control groups about the all tests of sway velocity (except on foam surface eyes closed test), end sway of tandem walk test, movement time of bilateral step up over test and lift up index of left step up over test. There was no significant correlation between static and dynamic balance parameters with MAF, BDI, PSQI, foot deformities and FAOS. The static and dynamic balance impairments are seen in PsA. As the balance parameters had no significant correlation with functional and clinical data, they are acceptable as independent parameters during the course of the disease