Perinatal Brachial Plexus Palsy: Review

WOS: 000259856300017Brachial plexus palsy is caused by a birth injury to the brachial plexus, the nerve network that controls movement and sensation of the arm. The main result of this injury is weak or paralyzed muscles in the shoulder, arm, and hand. Fortunately, most infants with this condition make complete spontaneous recovery. Some, however, are left with varying degrees of arm weakness. Among infants who do not recover spontaneously, some will require physical therapy and occupational therapy only, and others will need both therapy and surgery. Children who develop deformities in the shoulder, arm, or hand may need orthopaedic treatment. In all cases, treatment must be started early to ensure the greatest improvement. Brachial plexus palsy is diagnosed in the newborn. Primary physicians need to identify and refer patients to the multidisciplinary, brachial plexus team. During the first 2-6 months after birth, the specialists on the team work together to restore normal functioning of the infant's arm

SOMATOSENSORY EVOKED POTENTIALS OF HAND MUSCLES IN STROKE AND THEIR MODIFICATION BY BOTULINUM TOXIN: A PRELIMINARY STUDY

WOS: 000305814900004PubMed: 22674234Objective: To determine the effect of botulinum toxin A on spasticity and somatosensory evoked potentials of hand muscles in patients who have undergone cerebrovascular accident. Design: Preliminary, prospective, before-after study design. Patients: Six subjects prospectively followed after application of botulinum toxin A in the rehabilitation department of a university hospital. Methods: All patients underwent botulinum toxin A injection to the upper extremity muscles in varying combinations and carried out a home-based exercise programme. Primary outcome measure was median somatosensory evoked potential of hand muscles (N20). Secondary outcome measures were: spasticity assessed clinically by Modified Ashworth Scales (MAS); functional ability analysis assessed by Physician's Rating Scale (PRS); and functional difficulties reported by patients or their care-givers by patient disability and care-giver burden rating scale (PD & CBRS). Results: MAS, PRS and PD & CBRS improved with botulinum toxin A treatment. In the affected limb, N20 potentials were impaired compared with those in the unaffected side. With botulinum toxin A treatment, although improvement in overall N20-P25 amplitudes was significant, as a result of limited sample size, post hoc pair-wise comparisons with Bonferroni correction failed to yield any significant pairs. Conclusion: The improvement in the median somatosensory evoked potentials following botulinum toxin A treatment suggests that central somatosensory patterns in hemiplegia can be modified by peripheral inputs

Nurse’s Knowledge of Neuropathic Pain

The aim of our study was to determine the levels of information and awareness of the nurses who work on neuropathic pain in the departments of physical medicine and rehabilitation, neurology and neurosurgery. A total of 60 nurses (20 per each department) who work in the physical medicine and rehabilitation, neurology and neurosurgery departments of Beyhekim State Hospital of Konya in Turkey took part in the study. The level of information and awareness of the nurses on neuropathic pain were assessed via a questionnaire prepared by specialists in the light of recent literature. The questionnaire was composed of 30 questions including the definition, symptoms, treatment and management of neuropathic pain. None of 60 nurses participating in the study were given any previous in-service training on neuropathic pain. According to the assessments, 80% of nurses (48) were found not to have sufficient knowledge about definition of neuropathic pain; 83.3% (50) about diseases causing neuropathic pain; 83.3% (50) about symptoms of neuropathic pain; and 90% (54) about management of neuropathic pain. The findings obtained from the nurses of these three departments showed no statistically significant relation. Our findings indicated that the knowledge of participants’ about neuropathic pain who work in these three departments seriously lack of information. Informing nurses about neuropathic pain during in-service training will be an important step towards improving the quality of services provided

Polypharmacy in the Elderly: A Multicenter Study

Objective: The aim of this study was to evaluate the polypharmacy issue and its correlations with socio-economic variables in Turkish elderly patients

Polypharmacy in the Elderly: A Multicenter Study

WOS: 000270438400009PubMed ID: 19716065Objective: The aim of this study was to evaluate the polypharmacy issue and its correlations with socio-economic variables in Turkish elderly patients. Design: Cross-sectional Setting: Outpatient clinics of the medical schools, departments of physical medicine and rehabilitation from 12 provinces. Participants: A total of 1430 elderly in different geographical regions of Turkey during January 2007 to January 2008 were included. Measurements: Patients were interviewed using a questionnaire that included demographic characteristics, current medical diagnosis, and pharmaceuticals that are used by elderly. Demographical parameters were gender, age, marital status, number of children, level of education, province, and status of retirement. Results: The mean number of drugs was found to be higher in the females. There was a significant difference among age groups, marital status groups, and the number of children categories. The distribution of the number of drugs among education levels did not differ significantly, whereas the distribution of the number of drugs between the status of retirement and presence of chronic disease differed significantly. Conclusions: Polypharmacy is correlated with various factors including age, sex, marital status, number of children, status of retirement, and presence of chronic medical conditions but not educational status in our study group. (J Am Med Dir Assoc 2009; 10: 486-490

Current compherensive approach to Covid-19

This book, prepared by our Karamanoglu Mehmetbey and other faculty members by adding their current experiences during the pandemic process, is one of the leading scientific publications about the COVID-19 pandemic

Common Mistakes in the Dual-Energy X-ray Absorptiometry (DXA) in Turkey. A Retrospective Descriptive Multicenter Study

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