Femoral Neuropathy in a Patient with Rheumatoid Arthritis

Femoral mononeuropathy (FMN) as an extraarticular finding of rheumatoid arthritis (RA) is a phenomenon which has not been reported previously. We report a 53-year-old female patient with RA, presenting FMN findings during the course of the disease. On examination, right quadriceps and iliopsoas muscles showed grade 3 weakness on the Medical Research Council (MRC) scale. Sensory examination revealed sensory loss in the right medial leg and thigh. Patellar tendon reflex was absent in the right side. A diagnosis of a partial right femoral neuropathy was confirmed using nerve conduction study and electromyography. The probable mechanism of FMN was thought to be vasculitis

Comparison of Liver Safety of Favipiravir and Hydroxychloroquine in COVID-19 Treatment

Objective: Since the first case from Wuhan, China in December 2019, COVID-19 has spread all over the world and a pandemic was declared by the World Health Organization on January 30, 2020. While there are no specific effective antiviral drugs or vaccines to treat or to prevent COVID-19; favipiravir, hydroxy-chloroquine and their combination are used in the treatment of COVID-19 in Turkey. In this study, it was aimed to evaluate the demographic, clinical and laboratory findings, the treatments given and the effects of treatments on liver tests of the patients followed up with the diagnosis of COVID-19

Diagnostic Performance of Clinical Tests in Patients with Shoulder Pain

WOS: 000343521400010Objective: This study aimed to investigate the diagnostic performance of clinical tests applied to patients with shoulder pain at a physical therapy outpatient clinic. Magnetic resonance imaging (MRI) findings were the major determinants to evaluate the accuracy of the clinical tests. Also, the relationship between the MRI findings and the pain and functional status of the shoulder were evaluated. Material and Methods: Seventy-six patients, referred to a physical therapy outpatient clinic with shoulder pain, were included in the study. Physical examination of all patients and specific clinical tests were performed for different shoulder pathologies. Pain levels of patients were evaluated with the visual analog scale and functional status of the shoulder with the Shoulder Disability Questionnaire. All patients were evaluated with MRI. Sensitivity, specificity, and positive and negative predictive values of the clinical tests were evaluated on the basis of the MRI findings. Results: The sensitivity of the tests evaluating impingement and rotator cuff pathologies was found to be high, but specificity was low. Diagnostic performance of the drop arm test to determine the supraspinatus ruptures; Yocum test to determine the subacromial and subdeltoid effusion; Patte test and external rotation lag sign to determine infraspinatus tendon pathologies; speed test to determine biceps pathologies; and horizontal adduction test and painful arc test to determine acromioclavicular joint pathologies were found to be statistically significant. In this study, the severity of pain and shoulder pathologies showed no statistically significant correlation. In terms of functional status, high scores were achieved only in the bicipital tendinitis group. Conclusion: MRI findings show that patients with shoulder pain may have multiple pathological lesions. Despite the coexistence of multiple pathologies and low specificity of clinical tests, clinical tests evaluating shoulder pathologies have great importance in directing the clinicians to diagnose and plan treatments because of high sensitivity

The Effects of Coexisting Cervical Myofascial Pain Syndromes On Pain and Disability of the Computer Users With Cumulative Trauma Disorders

77th Annual Meeting of the American-College-of-Rheumatology / 48th Annual Meeting of the Association-of-Rheumatology-Health-Professionals -- OCT 25-30, 2013 -- San Diego, CAWOS: 000325359203067…Amer Coll Rheumatol, Assoc Rheumatol Hlth Profes

Acute Pancreatitis Caused By Mushroom Poisoning:A Report of Two Cases

Of the more than 5000 species of mushrooms known, 100 types are toxic and approximately 10% of these toxic types can cause fatal toxicity. A type of mushroom called Amanita phalloides is responsible for 95% of toxic mushroom poisonings. In this article, we report 2 cases of mushroom poisonings caused by Lactarius volemus, known as Tirmit by the local people. The patient and his wife were admitted to the emergency room with abdominal pain, nausea, and vomiting 20 hours after consuming Lactarius volemus, an edible type of mushroom. The patients reported that they had been collecting this mushroom from the mountains and eating them for several years but had never developed any clinicopathology to date. Further examination of the patients revealed a very rare case of acute pancreatitis due to mushroom intoxication. The male patient was admitted to the intensive care unit while his wife was followed in the internal medicine service, because of her relative mild clinical symptoms. Both patients recovered without sequelae and were discharged. In this article, we aimed to emphasize that gastrointestinal symptoms are often observed in mushroom intoxications and can be confused with acute pancreatitis, thus leading to misdiagnosis of patients. Early diagnosis and appropriate treatment can improve patients’ prognosis and prevent the development of complications.PubMedScopu

The Association of Skinfold Anthropometric Measures, Body Composition and Disease Severity in Obese and Non-obese Fibromyalgia Patients: A Cross-sectional Study

WOS: 000429930000008PubMed ID: 29900988Objectives: This study aims to determine the effects of obesity and obesity related anthropometric and body composition determiners on the severity of fibromyalgia syndrome (FS) and to compare obese, overweight and normoweight FS patients according to general health and psychological status. Patients and methods: The study included 42 obese (mean age 48.8 +/- 11.6; range 24 to 65 years), 27 overweight (mean age 47.3 +/- 3.4; range 24 to 61 years) and 32 normoweight (mean age 47.1 +/- 7.8 years; range 31 to 60 years) female FS patients. Widespread pain scores and symptom severity scores were noted. Pain pressure thresholds of tender points and control points were measured and total myalgic score (TMS) was calculated. The anthropometric assessments and skinfold measurements of all participants were recorded. Quality of life was evaluated by Health Assessment Questionnaire while psychological status was evaluated using Beck Depression Inventory. Results: Control points, TMS values and hand grip strength values of obese FS patients were significantly lower, while disease duration, symptom severity, widespread pain scores, visual analog scale and Health Assessment Questionnaire scores were significantly higher than normoweight and overweight FS patients. Fat free mass, fat mass, body fat percentage and waist/hip ratio values were significantly higher in obese FS patients than overweight and normoweight FS patients (p<0.001 for all values). Stepwise linear regression analysis showed that increased body mass index, decreased fat free mass (R2=0.11) and increased disease duration (R2=0.13) were associated with lower TMS. Conclusion: We found that obesity had significant negative effects on pain, disease severity and quality of life in patients with FS

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury