Pharmacological Treatment of Tourette Disorder

Tourette disorder is a chronic neuropsychiatric disorder characterized by vocal and motor tics. The course of the disorder shows waxing and vaning pattern and symptoms adversely affect patients’ quality of life. Patients use psychopharmacologic agents for long periods to control their symptoms during which they also struggle with drug related side effects. Clinicians face serious difficulties in controlling symptoms with psychopharmacological agents. Primarily alpha 2 receptor agonists and antipsychotic drugs have been used in the treatment of Tourette disorder. Risperidone and aripiprazole are the most commonly used new generation antipsychotics in the treatment. In addition there are contradictory findings regarding the use of dopamine agonists, tetrabenazine, topiramate, levatirasetame, and delta-9-tetrahydrocannabinol in these patient

Isokinetic Strength Profile Of Shoulder Internal And External Rotators Of Adolescent Volleyball Players

Objectives: The aim of this study was to investigate the effects of limb dominance and gender on isometric, eccentric and concentric strength of the shoulder internal and external rotator muscles in adolescent volleyball players. Methods: Forty adolescent volleyball players [Male: 23( Age: 15.5±1.4 yrs, Body weight: 72±10.2 kg, Height: 184.4±7.6 cm, BMI: 20.9±2.6 kg/m2), Female: ( Age: 16.7±0.9 yrs, Body weight: 60.7±8.2 kg, Height: 172.5±5.3 cm, BMI: 20.4±2.3 kg/m2) participated in this study. Isomed 2000 isokinetic dynamometer was used to measure muscle strength testing. Isometric strength testing of shoulder internal and external rotator muscles were performed at 90 ° shoulder abduction and external rotation position. In the same position, concentric and eccentric muscle testing was performed at 90°/s angular velocity. Strength outcomes were recorded as Nm/kg. 2-way repeated measures of ANOVA was used for statistical analysis. Results: Dominance by gender interaction was not found significant for internal rotator (IR) and external rotator (ER) muscles' strength (IR: F(1,72)=2.87, p=0.06, ER: F(1,72)=1.98, p=0.15). There was a significant strength by dominance interaction for internal rotator muscles (F(2,72)=18.52, p<0.001). Isometric strength was greater in dominant limb (p<0.001)while concentric strength was found greater in non-dominant limb(p=0.006). Eccentric strength was found similar for limbs (p=0.18). IR muscles showed greater strength during eccentric (1.03±0.05), concentric (0.76±0.03) and isometric test (0.69±0.03), respectively. On the other hand, external rotators showed greater strength during eccentric (0.49±0.4), isometric (0.40±0.3) and concentric test (0.36±0.3), respectively. There was no significant gender effect on the strength (IR: F(2,72)=0.31, p=0.73, ER: F(2,72)=0.42, p=0.66). Conclusion: The strength of shoulder internal and external rotator muscles do not differ according to gender in adolescent volleyball players. Limb dominance has an effect on the strength of internal rotator muscles while it has no effect on the strength of external rotators. Both muscle groups show greater strength during eccentric testing.PubMe

Effects On Lower Extremity Neuromuscular Control Exercises On Knee Proprioception, Muscle Strength, And Functional Level In Patients With Acl Reconstruction

Objective The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R). Materials and Methods Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated. Results There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I (p > 0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II (p < 0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups (p < 0.05). Conclusions The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.PubMedWoSScopu

Oxford Knee Score: Cross-Cultural Adaptation And Validation Of The Turkish Version In Patients With Osteoarthritis Of The Knee

Objective: The Oxford Knee Score (OKS) is a valid, short, self-administered, and site-specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. Methods: The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89 +/- 7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's alpha coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. Results: Internal consistency was high (Cronbach's alpha: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. Conclusion: The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.WoSScopu

Semitendinosus snapping: analysis of movement, electromyographic activities, muscle strength and endurance, motor control and joint position sense

A female ballet with a history of two-years of semitendinosus (ST) snapping was assessed. On physical examination snapping was observed during hyperextension of the knee. Neither any history of trauma nor treatment was recalled. Magnetic resonance imaging (MRI), movement analysis, onset timing of ST and Bisceps Femoris (BF), motor control, isokinetic muscle strength and endurance, joint position sense (JPS) were assessed. The MRI findings were normal. There were abnormal oscillations observed during hyperextension of the snapping knee compared to healthy side. There were no isokinetic muscle strength nor do muscle endurance differences. The motor control and JPS deficits were greater on the snapping knee than the healthy side. ST onset timing was earlier than BF on the snapping side. Snapping of the semitendinosus tendon has an adverse affect on JPS, motor control and onset timing of the knee muscle

Functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education. © 2023 The Author

functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study.

The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported “good” or “very good” outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education

Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective study

Cetinkaya, Esra/0000-0003-2415-1236; Taskiran, Bengur/0000-0003-4842-450X; MELEKOGLU, RAUF/0000-0001-7113-6691; pekkolay, zafer/0000-0002-5323-2257; Ozer, Alev/0000-0002-0934-0226; kilinc, faruk/0000-0002-0198-2558; Aygun, Elif Ganime/0000-0003-3737-7250; KARAKILIC, ERSEN/0000-0003-3590-2656; Aydin, Hasan/0000-0003-4246-0681WOS: 000457530200011PubMed: 30402933Aim Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. Methods We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. Results The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 +/- 5 vs. 28 +/- 5 years, P < 0.001) and heavier (mean BMI: 27.2 +/- 5.1 vs. 24.7 +/- 4.7 kg/m(2), P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m(2), no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). Conclusion The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required