As alterações do ângulo escapulotorácıco afetam o desenvolvımento de escápula alada e escores funcıonaıs durante o tratamento de fratura de clavícula?

Introduction: To compare surgical and conservative management of midshaft clavicle fractures according with scapulothoracic joint angle change, considering clinical, functional, and radiological outcomes. Methods: A total of 95 midshaft clavicle fracture patients aged between 18-70 years with a minimum follow-up duration of 12 months were included in this study. Patients were treated either conservatively (Group I) or surgically (Group 2). Plane deformities, scapulothoracic joint angle, shortness and isokinetic muscle strength were measured. Shoulder Pain, Disability Index (SPADI) and Short Form-36 (SF36) were assessed. Results: Scapulothoracic joint angles were higher in the conservative treatment group than in surgery group (p=0.036). Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Surgical treatment was associated with significantly better SF-36 physical scores and with SPADI pain and disability scores. However, the two groups did not differ in terms of isokinetic muscle strength. Negative anteroposterior plane deformity (p<0.001) and negative axial plane deformity (p=0.004) were more frequent in the conservative treatment group. Clavicle shortness was more common in the conservative treatment group. Conclusions: According to our findings scapulothoracic joint angle changes were seen in the conservative treatment group more than in the surgery group. Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Level of Evidence III; Retrospective comparative study.Introdução: Comparar o manejo cirúrgico e conservador das fraturas da diáfise da clavícula conforme alteração do ângulo escapulotorácico, considerando resultados clínicos, funcionais e radiológicos. Métodos: Um total de 95 pacientes com fratura do terço médio da clavícula com idade entre 18-70 anos, com um tempo mínimo de seguimento de 12 meses, foram incluídos neste estudo. Os pacientes foram tratados conservadoramente (Grupo I) ou cirurgicamente (Grupo 2). Deformidades planas, ângulo escapulotorácico, encurtamento e força muscular isocinética foram medidos. O Índice de Dor e Incapacidade do Ombro (SPADI) e a Short Form-36 (SF36) foram avaliados. Resultados: Os ângulos da articulação escapulotorácica foram maiores no grupo de tratamento conservador do que no grupo de cirurgia (p=0,036). Consequentemente, a escápula alada foi vista mais comumente no grupo de tratamento conservador do que no grupo de cirurgia (p=0,001). O tratamento cirúrgico foi associado a escores físicos SF-36 significativamente melhores e escores SPADI de dor e incapacidade. No entanto, os dois grupos não diferiram em termos de força muscular isocinética. A deformidade no plano anteroposterior negativo (p<0,001) e a deformidade no plano axial negativo (p=0,004) foram mais frequentes no grupo de tratamento conservador. O encurtamento da clavícula foi mais comum no grupo de tratamento conservador. Conclusões: De acordo com nossos achados, as alterações do ângulo escapulotorácico foram mais observadas no grupo de tratamento conservador do que no grupo de cirurgia. Consequentemente, a escápula alada foi vista mais comumente no grupo de tratamento conservador do que no grupo de cirurgia (p=0,001)

Diz osteoartrozunda konsantrik, kombine konsantrik-eksantrik ve izometrik egzersizlerin etkinliğinin karşılaştırılması

Diz OA'unda konsantrik, kombine konsantrik-eksantrik ve izometrik egzersiz programlarının ağrı, fonksiyonel durum ve kas kuvveti üzerine etkilerinin karşılaştırılması. Hastalar ve Metod: Selçuk Üniversitesi Meram Tıp Fakültesi Hastanesi Fiziksel Tıp ve Rehabilitasyon kliniğine başvuran ve bilateral diz OA'u tanısı alan 80 hasta çaışmaya alındı. Hastalar randomize olarak 4 gruba bölündü. İlk üç grup egzersiz gruplarını oluştururken, dördüncü grupta egzersiz uygulanmayan kontrol grubunu oluşturdu. Egzersiz gruplarından 1. gruba 60°/sn den 1807sn'ye kadar 30°/sn aralıklarla her hızda 12'şer konsantrik izokinetik kontraksiyon, 2.gruba yine aynı hız aralıklarında önce 6'şar konsantrik ardından 6'şar eksantrik izokinetik kontrakisyon ve 3. gruba da 15°den 75°'ye kadar (diz tam ekstansiyonda 0° kabul edilmek üzere) 15°'lik aralıklarla farklı açılarda 12'şer izometrik kontraksiyonu içeren egzersiz programı 8 hafta süre ile haftada 3 gün uygulandı. Kontrol grubuda dahil tüm hastalara programa başlamadan 0. haftada ve takiben 4. 8. ve 20.haftalarda VAS istirahat ve hareket, WOMAC, SF 36 ve diz ekstansör ve fleksör kas gruplarının pik tork ölçümleri yapıldı. Bulgular: Tüm egzersiz grupları ağn skorlarında, fonksiyonel kapasite ölçümlerinde ve kas güçlerinde belirgin gelişme gösterdiler. Ancak kontrol grubu ile karşılaştırıldığında bu gelişim izokinetik egzersiz gruplarında daha belirgin düzeydeydi (p<0,001-p<0,01). 12 haftalık tedavisiz dönemi takiben 20.haftada yaptığımız ölçümlerde her üç egzersiz grubunda da kazanımlarından belirgin kayıp saptanmadı (p<0,001- p<0,05). Ağn skorlannda azalma konsantrik grupta, fonksiyonel kapasitede artış da konsantrik-eksantrik grupta daha belirgin gibi durmaktaydı. Sonuç: Bu bulgular 8 hafta süre ile haftada 3 gün uygulanan egzersiz programlarının diz OA'unda kuvvet artışı, ağrı ve fonksiyonel kapasite de iyileşme sağladığını göstermiştir. Egzersiz bırakıldıktan sonra anlamlı kayıp saptanmamıştır. Konsantrik grupta ağrıda, konsantrik-eksantrik grupta ise fonksiyonel kapasitede daha belirgin iyileşme saptanmıştır. Bu bulgular diz OA'unda egzersizin önemini vurgularken bu konuda izokinetik teknolojinin oldukça yararlı olduğunu göstermiştir.To determine the effect of concentric, combine concentric-eccentric and isometric exercises programs on pain, functional capacity and muscle strength of patients with bilateral osteoarthrosis of the knee. Patients and Methods: 80 patient selected randomly from the patients that apply Physical Medicine and Rehabilitation clinic of Selçuk University Medical Faculty with knee pain and take the diagnosis of bilateral knee ostoarthritis.The patients randomly assigned into four groups. The patients at the first group performed 12 concentric isokinetic contraction of each knee flexor and extensor muscle group and the second group performed 6 concentric and after 6 eccentric isokinetic contraction of each knee muscle group by using a spectrum of angular velocities ranging from 60°/s to 180°/s with 30°/s intervals for both sides, 3 days a week for 8 weeks. The patients at the third group performed 12 isometric contravtion of each muscle groups at angles ranging from 15° to 75° (the extended knee is 0°) with 15° intervals for both sides, 3 days a week for 8 weeks. And the fourth group was the non-treatment, control group. We performed to all patients VAS at rest and activity, WOMAC, SF 36 and pik tork of knee extensor and flexor muscle groups, measurments at the begining, O.week and after at 4. 8. and 20.weeks. Results: All training groups showed marked decreases in pain scores and increases in fuctional capacity and PT of the knee extensor and flexor muscles (p<0,001-p<0,01). We didn't find significant loss at these paremeters after an 12 week non-treatment period (p<0,001- p<0,05). Pain relief at the concentric group and increase of functional capacity at the concentric-eccentric group was slightly better than the others. Conclusion: These results suggest that the regular exercise within 8 weeks for 3 days per week is possible to improve symptoms, functional capacity and the muscle strength in patients with O A of the knee. And the loss in improvement after 12 weeks of non- treatment period was'nt at sinificant rates. These findings emphazised the role of exercises and the isokinetic technology at OA

Ankilozan spondilit ve myotoni konjennita ilişkisi

Bu vaka ankilozan spondilit ve myotoni konjenitanın birlikte görüldüğü ilk sunumdur. Ankilozan spondilit aksiyal iskelet infla- masyonu ve sistemik tutulumla karekterize sistemik romatolojik bir hastalıktır. Miyotoninin en belirgin bulgusu tutukluk ve kas kasıldıktan sonra gevşeme gecikmesidir. Tutukluk ve tanı gecikmesi bu iki hastalıkta ortak bulgudur.This is the first report about the association of ankylosing spondylitis and myotonia congenita. Ankylosing spondylitis is a systemic rheumatologic disease that is characterized by axial skeletal inflammation and accompanied by systemic involvement. The most significant findings of myotonia are the stiffness and the delayed relaxation following the muscle contraction. Both of these pa- thologies can cause stiffness and also delaying of diagnosis of each other

Ankle joint position sense in male taekwondo athletes after wobble board training

Background There is evidence of an improvement in sportive performance in the athletes after completing a wobble board training program. The aim of this study was to determine whether a six-week wobble board training increased the awareness of joint position sense on ankle joint proprioception in male taekwondo athletes. Material/Methods: Eighteen male taekwondo athletes took part in this study. Participants were randomly divided into experimental and control groups. For experimental group (n=10) the average age, height, weight and experience time of the subjects were 19.50±2.07 years, 175.80±7.27 cm, 64.80±4.71 kg and 6.30±1.49 years, respectively. For control group (n=8) it was 19.88±2.30 years, 173.75±5.06 cm, 67.50±5.55 kg and 7.13±2.56 years, respectively. Experimental group took wobble board was training three times a week for the period of six weeks. To assess ankle joint position sense (JPS), passive angle reproduction test was performed by the Biodex System 3 Dynamometer (Biodex Medical Systems, Shirley, NY, USA). Passive angle reproduction test was conducted on dominant and nondominant ankle at 5° and 25° of plantar flexion angles. Measurements were taken twice, before and after training. Results: There was no significant difference in dominant ankle at 5° between JPS measurements before and after training in experimental group (t=1.920, p=0.087). JPS increased significantly in dominant ankle at 25° (t=3.060, p=0.014), non-dominant ankle at 5° (t=2.959, p=0.016) and 25° (t=3.213, p=0.011) in exerimental group. Conclusions: The WBT of taekwondo athletes had improved JPS, especially in non-dominant ankle. The proprioception training with wobble board may provide an advantage in using dominant leg during performing taekwondo sport moves and in decreasing the number of ankle injuries in male taekwondo athletes. © ARCHIVES OF BUDO

Lightweight aggregates coated with colemanite

WOS: 000403196900002Technological advancements in the field of building materials are achieved day by day. In this study, a new lightweight concrete aggregate is produced by mixing certain rates of colemanite (0%, 7.5%, 12.5%, 17.5%), cement and coating the surface of pumice aggregate with this mixture. Thin aggregate sections are analyzed with specific gravity, unit weight, water absorption, impact, and crushing experiments. In this way, the production of cement and cement+colemanite coated lightweight concrete aggregates is investigated and an opinion on the likely behavior of these concrete types is provided

Internal structure examination of lightweight concrete produced with polymer-coated pumice aggregate

In the construction sector, pumice is observed to be used in both structural and non-structural building elements. In this study, to produce a new kind of concrete, the aggregates are coated with three different polymers (Sonomeric1 : SNMC, KB Pur 214: KBP and Polipol3455: PLP) that have multiple uses. The mineralogical-petrographical features of both polymer-coated and uncoated aggregates were examined, and SEM (Scanning Electron Microscope) and XRD (X-ray Diffraction) analyses were performed. Moreover, in the study, lightweight concrete elements with different dosages (300, 400 and 500) were produced by using polymer-coated and uncoated aggregates; and their internal structure examinations were performed and compressive strength values of 3, 7 and 28 days samples were investigated. As a conclusion; among the aggregate samples, it was determined that PLP-coated aggregates have a more porous structure than the other polymer-coated aggregates and KBP-coated aggregates could be used in lightweight concrete (500 dosage) production. It was also concluded that the compressive strength values of lightweight concrete elements produced with coated samples increased even more. (C) 2013 Elsevier Ltd. All rights reserved.WOS:0003238612000532-s2.0-8488071474

Quality of Life in Osteoporosis: A Controlled Study

Aim: To evaluate quality of life in women without vertebral and nonvertebral fractures, with postmenopausal osteoporosis (PMO), osteopenic and normal bone mineral density (BMD), and to determine effective factors on quality of life. Materials and Methods: Without fractures, 266 women with PMO, 310 with osteopenia and 255 with normal women BMD were enrolled in the study. BMD measurement was performed on lumbar vertebra (L1-L4) and femur neck via dual energy X-ray absorbtiometry (DXA). Quality of life was assessed with Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). QUALEFFO total scores and subscales were compared in all groups. Factors about quality of life in women with PMO were defined with correlation analysis. Variations of the highest correlation and quality of life were included into linear regression model. Results: In non-fractured women with PMO, QUALEFFO total scores and subscales were higher than those with osteopenia and normal BMD. In women with PMO, a positive correlation was found between QUALEFFO total scores, and age, Body Mass İndex (BMI), parity and duration of menopause, and a negative correlation between QUALEFFO total scores, and level of education, economical status and femur neck BMD scores. In linear regression analysis, among significant factors of quality of life were BMI, femur neck BMD, parity and duration of menopause. Conclusion: Our results indicate that quality of life in non-fractured women with PMO is disordered higher than those with osteopenia and normal BMD, and quality of life are affected by numerous factors. (Turkish Journal of Osteoporosis 2012;18: 47-52

Permeability features of concretes produced with aggregates coated with colemanite

WOS: 000358476400007In the world total boron reserve rating, Turkey is taken place on the first rank, meeting the demand of refined mineral and main boron chemicals. Development of the new boron products and production technologies, spreading the using area of the boron are the study topics which must be finically discussed. In this study, with the help of colemanite taken in ratio as (0%, 7.5%, 12.5%, and 17.5%) by being mixed by the cement, surfaces of the pumice aggregates have been covered. Permeability of the samples has been investigated by producing lightweight concrete with 400 dose with the help of aggregates covered with colemanite. For this, the experiments of water absorption, capillary water absorption, depth of penetration of water under pressure and rapid chloride permeability have been performed. In addition, analyses of the thin section of covered and uncovered pumice aggregates and SEM (Scanning Electron Microscope) have been investigated. When the control samples produced with the covered aggregates and concretes produced with colemanite covered aggregates are compared each other, it has been determined that special lightweight concretes whose values of capillary water absorption experiment, depth of penetration of water under pressure experiment and rapid chloride permeability are low can be produced

Reproduktif faktörlerin kemik mineral dansitometresi üzerine etkileri

Amaç: Postmenopozal kadınlarda reprodüktif faktörlerin kemik mineral yoğunluğu (BMD) üzerine etkilerini tespit etmek amaçlandı. Gereç ve Yöntemler: Çalışmaya lomber vertebra (L1-4) (LS) ve femur boyun (FN) düzeyinde BMD (gr/cm²) ölçümleri yapılmış olan 1196 postmenopazal kadın dahil edildi. Hastaların demografik, reprodüktif özellikleri ve vücut kütle indeksi (BMI) (kg/m²) belirlendi. BMD ile ilişkili faktörleri belirlemede çoklu regresyon analizi kullanıldı. Bulgular: Hastalarda ortalama yaş 59,978,56, ağırlık 73,4913,06 kg, VKİ 29,255,22 kg/m², adet yaşı 14,001,64, doğum sayısı 4,222,09, toplam emzirme süresi 60,7738,80 ay, günlük emzirme sayısı 8,233,91, menapoz yaşı 47,124,22, menopoz süresi 12,809,10 yıl, LS BMD 0,9930,171 gr/cm², FN BMD 0,8440,14 gr/cm² idi. Hastalarda LS BMD ve FN BMD değerleri ile yaş, menopoz süresi, toplam emzirme süresi, günlük emzirme sayısı arasında negatif korelasyon saptandı. LS ve FN BMD değerleri ile, ağırlık ve BMI skorları arasında pozitif korelasyon saptandı Yine LS ve FN BMD değerleri ile adet yaşı ve doğum sayısı arasında negatif korelasyon saptandı. Lineer basamak regresyon analizlerinde, ağırlık (p0,001), günlük emzirme sayısı (p0,001), menapoz sonrası geçen süre (p0,001), toplam emzirme süresi (p0,012), ilk adet yaşı (p0,007) LS BMD için, ağırlık (p0,001), menapoz sonrası geçen süre (p0,001) ve günlük emzirme sayısı (p0,001) FN BMD için en önemli belirleyiciler olarak bulundu. Sonuç: Postmenopozal dönemdeki kadınlarda LS ve FN BMD, reprodüktif faktörler ile ilişkili gözükmektedir. Bu nedenle postmenopozal kadınlarda osteoporoz risk faktörleri değerlendirirken reproduktif faktörlerde dikkate alınmalıdır. (Türk Os te opo roz Dergisi 2012;18:8-12)Aim: To determine the effects of reproductive factors on bone mineral density (BMD) in postmenopausal women. Materials and Methods: A total of 1196 postmenopausal women with BMD (g/cm2) measurements at lumbar vertebra (LS) and femur neck (FN) were enrolled. Demographic, reproductive characteristics and Body Mass Index (BMI) of patients were defined. In order to define BMD related factors, multiple regression analysis was employed. Results: Main results were as follows: mean age 59.97±8.56 yrs; weight 73.49±13.06 kg; BMI 29.25±5.22kg/m&sup2;, age of menarche 14.00±1.64 yrs; number of deliveries 4.22±2.09; total breastfeeding duration 60.77±38.80 months; number of breastfeeding per day 8.23±3.91; menopausal age 47.12±4.22 yrs; duration of menopause 12.80±9.10 yrs; LS BMD 0.993±0.171 gr/cm2; FN BMD 0.844±0.14 gr/cm2. There were negative correlations between LS BMD and FN BMD values and age, menopause duration, total breastfeeding duration, and number of breastfeeding per day. There were positive correlations between LS and FN BMD values, and weight and BMI scores. Additionally, there were negative correlations between LS and FN BMD values, and age of menarche and number of deliveries. In linear stage regression analysis, weight, number of breastfeeding per day, postmenopausal duration, duration of total breastfeeding and age of menarche were defined as the most significant predictors for LS BMD, whereas weight, postmenopausal duration and number of breastfeeding per day were defined as the most significant predictors for FN BMD. Conclusion: LS and FN BMD in postmenopausal women are related to reproductive factors, so reproductive factors should also be considered in the evaluation of risk factors in postmenopausal women. (Turkish Journal of Osteoporosis 2012;18:8-12