Selective COX-2 inhibition with different doses of rofecoxib does not impair endothelial function in patients with coronary artery disease.

In this study, we investigated the effects of both 25 and 50 mg daily doses of rofecoxib on the endothelial functions of patients with coronary artery disease (CAD). For this purpose, 34 patients with documented severe CAD and who were under aspirin treatment (300 mg/day) were randomized to receive 4 weeks of treatment with a placebo (n = 10, group I), rofecoxib 25 mg/day (n = 12, group II), and rofecoxib 50 mg/day (n = 12, group III). Brachial artery vasodilator responses were measured in order to evaluate endothelial function. The percentage of change in endothelial-dependent vasodilation in groups I, II, and III were similar at the baseline level and showed no significant change after treatment (6.2+/-3.9% vs. 5.9+/-3.1% and 5.8+/-3.3% vs. 5.6+/-3.8% and 6.1+/-4.5% vs. 5.8+/-4.1%, respectively; P &#62; 0.05). Compared with the baseline, endothelium-independent vasodilatation, as assessed by nitroglycerine (NTG), remained unchanged after the treatment period (11.2+/-6.9% vs. 10.3+/-7.1% and 11.2+/-6.3% vs. 9.9+/-5.1% and 9.5+/-4.9% and 8.8+/-4.6%, respectively; P&#62; 0.05). Treatment with both doses also showed no significant effects on high-sensitivity C-reactive protein (hs-CRP) levels and resting arterial diameters (P &#62; 0.05). In conclusion, 4 weeks of treatment with standard and high doses of rofecoxib showed no significant effects on either endothelial-dependent or independent vasodilator response or plasma hs-CRP levels in patients with severe CAD taking concomitant aspirin.</p

Comparison of intra-articular injections of Hyaluronic Acid and Corticosteroid in the treatment of Osteoarthritis of the hip in comparison with intra-articular injections of Bupivacaine. Design of a prospective, randomized, controlled study with blinding of the patients and outcome assessors

<p>Abstract</p> <p>Background</p> <p>Although intra-articular hyaluronic acid is well established as a treatment for osteoarthritis of the knee, its use in hip osteoarthritis is not based on large randomized controlled trials. There is a need for more rigorously designed studies on hip osteoarthritis treatment as this subject is still very much under debate.</p> <p>Methods/Design</p> <p>Randomized, controlled trial with a three-armed, parallel-group design. Approximately 315 patients complying with the inclusion and exclusion criteria will be randomized into one of the following treatment groups: infiltration of the hip joint with hyaluronic acid, with a corticosteroid or with 0.125% bupivacaine.</p> <p>The following outcome measure instruments will be assessed at baseline, i.e. before the intra-articular injection of one of the study products, and then again at six weeks, 3 and 6 months after the initial injection: Pain (100 mm VAS), Harris Hip Score and HOOS, patient assessment of their clinical status (worse, stable or better then at the time of enrollment) and intake of pain rescue medication (number per week). In addition patients will be asked if they have complications/adverse events. The six-month follow-up period for all patients will begin on the date the first injection is administered.</p> <p>Discussion</p> <p>This randomized, controlled, three-arm study will hopefully provide robust information on two of the intra-articular treatments used in hip osteoarthritis, in comparison to bupivacaine.</p> <p>Trial registration</p> <p>NCT01079455</p

A rare cause for a gluteal pain in adults: tuber ischium avulsion fracture

Tuber iskium avülsiyon kırığı nadir görülen ve bu nedenle bazen tanısı konulamayan veya tanı konulması geciken bir yaralanmadır. Genellikle ergen sporcularda, hamstring kasının şiddetli kontraksiyonları sonrasında gelişmektedir. Bu yazıda inguinal herni ameliyatı sonrasında gluteal bölgede ağrı yakınmasıyla başvuran 28 yaşında erkek hastada gelişen tuber iskium avülsiyon kırığı olgusu sunulduTuber ischium avulsion fracture is a rare injury, of which the diagnosis is often missed or delayed. It usually occurs as a result of hamstring muscle contraction in adolescent athletes. Herein, we report a tuber ischium avulsion fracture developed in a 28-year-old male patient, who was admitted with the complaint of pain in the gluteal area after inguinal hernia surger

Soulder paresis due to Herpes zoster neuritis: A case report

Bu olgu sunumunda, herpes zoster (HZ) enfeksiyonu sonrası gelişen ve tek taraflı C5-6 innervasyonlu kaslarda güçsüzlük ile seyreden bir segmenter motor parezi (SMP) vakası sunulmuştur. Günlük yaşam aktivitelerinin belirgin derecede kısıtlandığı olguda elektrofizyolojik olarak üst brakiyel pleksus nöriti saptanmış ve uygulanan fizik tedavi programı ile kısa sürede nörolojik semptomlar ve elektrofizyolojik bulgularda düzelmeler kaydedilmiştir. Bu vakayı sunmaktaki amacımız, omuz patolojileri arasında HZ'e bağlı SMP'nin de akılda tutulması gereğini vurgulamak ve bu vaka nedeniyle mevcut literatürü gözden geçirmektir.In this case report, a patient with the diagnosis of segmental motor paresis (SMP) following herpes zoster(HZ) infection which involved C5-6 roots was presented. The muscle weakness was prominent at the muscles of the right shoulder and his daily activities were significantly restricted. Electrophysiological study revealed neuritis in the upper brachial plexus. After application of physical rehabilitation, significant improvement was observed in symptoms and electrophysiological findings. Our aim to present this case is to review the literature published until now in this regard and to emphasize that post-herpetic neuritis may involve in the etiology of shoulder disorders

The effect of bisphosphonate treatment on blood lipid parameters in patients with postmenopausal osteoporosis

Bifosfonatlar günümüzde östeoporoz ve Paget hastalığı gibi metabolik kemik hastalıklarının tedavisinde yaygın olarak kullanılan ilaç grubudur. Kesin etki mekanizmaları bilinmemekle birlikte özellikle amin grubu içeren bifosfonatların (aminobifosfonat) mevalonat yolunu inhibe ederek Osteoklast aktivasyonunu azalttığrgösterilmiştir. Kolesterol sentezinin de mevalonate yoluyla olması, bu grup ilaçların kolesterol metabolizmasını da etkileyebileceğini düşündürmektedir. Bu çalışmada, östeoporoz tanısı konularak tedavi amacıyla aminobifosfonat başlanılan olgularda kan lipid parametrelerindeki değişiklikler araştırılmıştır. Bu amaçla çalışmaya toplam 50 osteoporotik postmeno-pozal hasta alınmış olup, 25 hastaya (ort.yaş:54±9 yıl) alendronat sodyum (70mg/hafta), 25 hastaya da (ort.yaş:55±8 yıl) risedronat sodyum (35mg/hafta) başlanmıştır. Ölçümler başlangıçta ve 6 aylık tedavi sonrasında yapılmıştır. Kan lipid parametreleri olarak; total kolesterol (T-kol), yüksek dansiteli kolesterol (HDL-kol), düşük dansiteli kolesterol (LDL-kol), trigliserid, apolipoprotein A (Apo-A), apolipoprotein B (Apo-B), lipoprotein (a) (Lip a) ve kemik döngüsünü gösteren parametreler olarak da; serumda total alkalen fosfataz (TAP), kemik-spesifik alkalen fosfataz (BAP), osteokalsin (OCL) ve idrarda deoksipiridinolin (DPD) düzeyleri değerlendirmeye alınmıştır. Altı aylık tedavi sonrasında her 2 grupta biyokimyasal olarak ölçülen kemik döngüsüne ait parametrelerde anlamlı değişiklikler olmasına karşın .(p0,05). Sonuçlarımız orta süreli oral aminobifosfonat tedavisinin kan lipid profili üzerine etki-sinin olmadığını düşündürmüştür.Bisphosphonates are currently the most preferred class of drugs used for the treatment of metabolic bone disease such as osteoporosis and Paget's disease. Although their exact mechanism has not been identified, the compounds containing amino group (amino bisphosphonates) were shown to decrease osteoclast activation by inhibiting mevalonate pathway. Because mevalonate pathway is essential in production of cholesterol, these compounds could also interfere with cholesterol synthesis. In the present study, the effects of aminobisphosp-honates on lipid parameters in subjects who were diagnosed as osteoporosis were investigated. For this re-ason, 50 postmenopausal osteoporotic subjects were included in the study and 25 of them (mean age:54&plusmn;9 years) received alendronate sodium (70mg/week) and the remaining 25 subjects (mean age:55&plusmn;8 years) were given risedronate sodium (35mg/week). Blood samples were analyzed at baseline and at the end of sixth months. Total cholesterol, high density cholesterol (HDL-chol), low density cholesterol (LDL-chol), triglyceride, apolipoprotein A (Apo-A), apolipoprotein B (Apo-B) and lipoprotein (a) (Lip a) were investigated as lipid pa-rameters. Total alkaline phophatase (TAP), bone-specific alkaline phophatase (BAP), osteocalcine (OCL) and urine deoxyprydolin (DPD) levels were assessed as bone remodeling markers. After six month treatment period, while significant changes were observed in bone remodeling parameters (p&lt;0.05), no significant changes were found in all measured lipid parameters (p&gt;0.05). Our results suggest that moderate-term oral aminobisfosphonate treatment has no significant effect on blood lipid paramete

Comparison of the efficacy of low-level laser therapy and pulsed ultrasound treatment in carpal tunnel syndrome: a placebo-controlled study

Amaç: Karpal tünel sendromunda (KTS) düşük enerjili lazer (DEL) ve kesikli ultrason (US) tedavilerinin etkinliklerini değerlendirmek ve karşılaştırmaktır. Gereç ve Yöntem: KTS tanısı alan toplam 60 hasta rastgele yöntemle dört gruba ayrıldı: Grup 1 e kesikli US, Grup 2 ye plasebo US, Grup 3 e DEL, Grup 4 e ise plasebo lazer tedavisi üç hafta boyunca haftada beş gün uygulandı. Hastalar tedavi öncesi ve tedavi sonrası 3, 6 ve 12. aylarda klinik ve elektrofizyolojik olarak değerlendirildi. Klinik değerlendirmede ağrı, uyuşukluk, el kavrama gücü ve Boston anketi ile semptom şiddet ve fonksiyonel kapasite değerlendirildi. Bulgular: Çalışma 52 hasta ve toplam 101 el ile tamamlandı. Hastaların genel özellikleri ve bazal elektrofizyolojik değişkenleri dört grupta da benzerdi. Ağrı, duyu kaybı, semptom şiddet skoru ve fonksiyonel kapasite skorlarında hem US hem de DEL gruplarında tedavi öncesine göre anlamlı düzelmeler saptandı (p0,05). Elektronörofizyolojik değişkenlerde, dört grupta da tedavi öncesine göre anlamlı değişimler saptanmadı (p>0,05). Klinik parametreler bakımından kesikli US tedavisinin DEL tedavisinden üstün olduğu tespit edildi (p<0,05). Sonuç: KTS de US ve DEL tedavisinin subjektif klinik semptomlar üzerine etkili, ancak elektrofizyolojik parametreler üzerine etkili olmadığı, kesikli US tedavisinin klinik parametreler göz önüne alındığında DEL tedavisinden daha üstün olduğu gösterilmiştir. Türk Fiz T p Re­hab Derg 2013;59:201-8.Objective: To evaluate the effect of low-level laser treatment (LLLT) and pulsed ultrasound (US) treatment in carpal tunnel syndrome (CTS) and to compare the effects of both treatment modalities. Materials and Methods: 60 patients diagnosed with CTS were randomly divided into four groups as US group (group 1), placebo US group (group 2), LLLT group (group 3) and plasebo LLLT group (group 4). Both treatments were applied five days a week for three weeks. Clinical and electrophysiological assessments were performed before and 3, 6 and 12 months after treatment. Pain, hypoesthesia and handgrip strength were evaluated. The Boston Questionnaire was used to assess the severity of symptoms and functional status. Results: 52 patients with 101 hands completed the study. Demographic and electrophysiological parameters were similar in the four groups. Both pulsed US treatment and LLLT were found to provide significant improvements in clinical parameters such as pain, sensory loss, symptom severity score and functional capacity score (p&lt;0.05). No significant beneficial effect was observed in both placebo groups (p&lt;0.05). Evaluations of the electrophysiological parameters showed no significant difference between the groups (p&gt;0.05). In terms of clinical efficacy, pulsed US was found to be superior to LLLT (p&lt;0.05). Conclusion: The two treatment modalities showed significant improvements in subjective clinical symptoms while no significant changes were observed in any electrophysiological parameters. Turk J Phys Med Rehab 2013;59:201-8