Assessment of relationship between pain, psychological status, quality of life and body mass index

Objective: The purpose of the study is to evaluate health-related quality of life (HRQL), pain, the number of painful areas, and depression level; both to compare obesity level and these parameters, and to compare between obese and non-obese participants. Materials (Subjects) and Methods: 1875 voluntary patients were evaluated. Patients were grouped into 5 according to body mass index (BMI) values: Group 1:17-24.99kg/m2, Group 2:25-29.99kg/m2, Group 3:30-34.99kg/m2, Group 4:35-35.99kg/m2, Group 5: BMI more than 40kg/m2. Patients were asked to fulfill a questionnaire about demographic data and a number of painful areas (neck, shoulder, elbow, wrist, back, low back, knee, ankle, and temporomandibular joint). All patients were evaluated with visual analog scale (VAS), for pain, short form-36 (SF-36) for HRQL, Beck Depression Scale (BDS) for depression level. Results:We have included 1832 patients (460 male, and 1372 female) in the study: Group 1: 285(16%), Group 2: 623(34%), Group 3: 653(36%), Group 4: 190(10%), Group 5: 81(4%). When the groups was compared according to VAS scores during activity; all other groups was higher than group 1 (p<0.01). When the BDS scores were compared; depression levels were higher in group 5 than the other groups. When a number of painful areas were compared; groups 3,4,5 had higher values than groups 1,2, and group 2 had higher values than group 1 (p<0.001). Conclusion: This study evaluates pain level, the number of painful areas, physical HRQL, and depression levels of pre-obese and obese patients using VAS, BDS, and SF-36 scores and proves negative effects when compared to the healthy population. But this effect does not correlate with BMI levels.Objective: The purpose of the study is to evaluate health-related quality of life (HRQL), pain, the number of painful areas, and depression level; both to compare obesity level and these parameters, and to compare between obese and non-obese participants. Materials (Subjects) and Methods: 1875 voluntary patients were evaluated. Patients were grouped into 5 according to body mass index (BMI) values: Group 1:17-24.99kg/m2, Group 2:25-29.99kg/m2, Group 3:30-34.99kg/m2, Group 4:35-35.99kg/m2, Group 5: BMI more than 40kg/m2. Patients were asked to fulfill a questionnaire about demographic data and a number of painful areas (neck, shoulder, elbow, wrist, back, low back, knee, ankle, and temporomandibular joint). All patients were evaluated with visual analog scale (VAS), for pain, short form-36 (SF-36) for HRQL, Beck Depression Scale (BDS) for depression level. Results:We have included 1832 patients (460 male, and 1372 female) in the study: Group 1: 285(16%), Group 2: 623(34%), Group 3: 653(36%), Group 4: 190(10%), Group 5: 81(4%). When the groups was compared according to VAS scores during activity; all other groups was higher than group 1 (p<0.01). When the BDS scores were compared; depression levels were higher in group 5 than the other groups. When a number of painful areas were compared; groups 3,4,5 had higher values than groups 1,2, and group 2 had higher values than group 1 (p<0.001). Conclusion: This study evaluates pain level, the number of painful areas, physical HRQL, and depression levels of pre-obese and obese patients using VAS, BDS, and SF-36 scores and proves negative effects when compared to the healthy population. But this effect does not correlate with BMI levels

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Comparıson of the effectıveness of dıfferent exercıse programs ın treatment of faıled back surgery syndrome

Başarısız bel cerrahisi sendromu (BBCS) lumbosakral omurga cerrahisini takiben hiç kaybolmayan ya da bir süre sonra yeniden ortaya çıkan dirençli veya tekrarlayıcı ağrı olarak tanımlanan önemli bir kronik bel ağrısı nedenidir. Spinal cerrahi geçiren hastaların yaklaşık olarak % 10-40' ında BBCS geliştiği bildirilmektedir. Özellikle günlük yaşam aktivitelerini önemli derecede kısıtlayan bu klinik tabloda tedavide; medikal tedavi, fizik tedavi, psikotrop ilaçlar, biofeedback, eğitim, kognitif ve davranışsal terapiyi kapsayan interdisipliner bir program izlenmelidir. Tedavinin amacı fonksiyonu arttırmak, ağrıyı azaltmak ve fiziksel aktiviteyi arttırmaktır.Bu çalışmanın amacı BBCS tedavisinde farklı egzersiz programlarının ağrı, fonksiyonel kapasite ve lomber ve diz kas kuvvetleri üzerindeki etkilerini araştırmaktı.Hastalar ve yöntem;Prospektif, randomize ve kontrollü olarak tasarlanan çalışmamıza Selçuk Üniversitesi Meram Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı Polikliniklerine başvuran BBCS tanısı alan 80 hasta alındı. Hastalar randomize olarak 4 gruba ayrıldı. Tüm gruplardaki hastalar doktor tarafından anlatılan, hasta eğitim programı içerikli bel okuluna katıldı. Ayrıca birinci gruba izometrik egzersiz programı, 2. gruba Dinamik Lomber Stabilizasyon (DLS) egzersiz programı ve 3. gruba ev egzersiz programı verildi. Dördüncü grup ise kontrol grubu olarak alındı. Çalışmaya alınan hastalar; tedavi öncesinde, 8 hafta süren tedavi protokolü sonrasında, 3. ve 6. ay kontrollerinde lomber mobilite açısından; El parmak zemin mesafesi (EPZ), lomber Schober (LS), Modifiye LS ile, ağrı açısından vizüel analog ağrı skalası (VAS) ile, dizabilite açısından Modifiye Oswestry Dizabilite İndeksi (MODİ) ile, depresyon açısndan Beck Depresyon İndeksi (BDİ) ile, korku-kaçınma tutumları açısından Korku Kaçınma Tutumları Anketi (KKTA) ile, dinamik kaldırma kapasitesi açısından progresif isoinertial ağırlık kaldırma (PİLE) testi ile, objektif lomber ve diz kas gücü ölçümü açısından izokinetik dinamometre ile değerlendirildi.Bulgular;Çalışmamızda tedavi öncesi değerlendirmelerde gruplar arasında demografik veriler ve klinik değerlendirme parametreleri açısından anlamlı bir fark yoktu (P > 0,05). Çalışma sonunda İzokinetik ve DLS egzersiz tedavisi alan gruplarda tedavi sonu ölçümlerde tüm parametrelerde iyileşme kaydedildi (P 0,05). Gruplar arası karşılaştırmada 1. ve 2. grupların tedavi sonrası tüm parametrelerde 4. gruba göre daha başarı olduğu gözlendi (P 0,05). At the end of treatment we found improvement in all parameters at isokinetic and DLS exercise groups (P 0.05). Between group comparisons we observe that the first and second groups are more successful than the fourth group in all parameters after treatment (P <0.05). Also, the first and second groups are more prominent than the third group in mobility, VAS, BDI and lumbar muscle strenght parameters at the end of the treatment (P <0.05).Results;In the treatment of FBSS, exercise therapy gives good results at lumbar mobility, pain, disability, fear-avoidance beliefs, depression, weight-bearing capacity, lumbar, and knee muscle strength measurements. In addition, according to the results of our study, isokinetic and DLS exercise programs are prominent exercise protocols in patients with FBSS

The Turkish adaptation and psychometric properties of the Geriatric Anxiety Scale

The purpose of the present study is to translate and adapt the Geriatric Anxiety Scale (GAS), a 30-item self-report measure of anxiety among older adults, into Turkish and examine its basic psychometric properties. We tested the translated GAS in a sample of community-dwelling older adults in Konya, Turkey (N=100; Mage=71.4 years, SD=6.5; range=65-88) without a history of mental disorder and sufficient cognitive abilities. To assess the convergent validity, Turkish versions of the Beck Anxiety Inventory (BAI) and Geriatric Depression Scale (GDS) were administered. The mean GAS total score was 13.33 (SD=11.86). Due to low item-total correlations (<0.30), two items (items 2 and 3) were removed from the Turkish version of the GAS. The internal reliability (Cronbach’s alpha) was excellent for the total score (0.91) and acceptable for the subscales (somatic = 0.71; cognitive = 0.85; affective = 0.84). Regarding the convergent validity, the GAS total score was significantly and positively correlated with the total scores of the BAI (r=0.87, P<0.05) and GDS (r=0.57, P<0.05), with large effect sizes. Implications: The newly translated Turkish version of the GAS has promising utility in an older adult Turkish sample. Future studies of this measure are warranted

The Turkish adaptation and psychometric properties of the geriatric anxiety scale

Purpose of the Study: To translate and adapt the Geriatric Anxiety Scale (GAS), a 30-item self-report measure of anxiety among older adults, into Turkish and examine its basic psychometric properties. Design and Methods: We tested the translated GAS in a sample of community-dwelling older adults in Konya, Turkey (N = 100; M age = 71.4 years, SD = 6.5; range = 65-88) without a history of mental disorder and sufficient cognitive abilities. To assess the convergent validity, Turkish versions of the Beck Anxiety Inventory (BAI) and Geriatric Depression Scale (GDS) were administered. Results: The mean GAS total score was 13.33 (SD = 11.86). Due to low item-total correlations (&lt; .30), two items (items 2 and 3) were removed from the Turkish version of the GAS. The internal reliability (Cronbach's alpha) was excellent for the total score (.91) and acceptable for the subscales (somatic = .71; cognitive = .85; affective = .84). Regarding the convergent validity, the GAS total score was significantly and positively correlated with the total scores of the BAI (r = .87, p &lt; . 05) and GDS (r = .57, p &lt; . 05), with large effect sizes. Implications: The newly translated Turkish version of the GAS has promising utility in an older adult Turkish sample. Future studies of this measure are warranted. © 2018 Mental Illness

Postpartum Unilateral Sacral Stress Fracture Mimicking Lumbar Radiculopathy: Case Report

Postpartum sacral stress fracture is a very rare clinical entity. Because of the ambiguous clinical and radiological findings, it is often diagnosed late. A case of a postpartal 25-year-old female patient presented with acute onset of low back pain radiating to the right extremity, mimicking lumbar radiculopathy. Magnetic resonance imaging of sacrum revealed a non-displaced stress fracture of the right sacral ala. The 25-hydroxy vitamine D level of the patient was very low; dual energy X-ray absorptiometry measurements were in the normal range. The patient is completely cured as a result of conservative treatment. As a result, sacrum stress fracture should be kept in mind in the presence of back pain during pregnancy and postpartum period

Effect of exercise doses on functional recovery in neonatal brachial plexus palsy: A randomized controlled study

WOS: 000460612600001PubMed ID: 31180384OBJECTIVE: The aim of this study was to examine how much recovery upper obstetric brachial plexus palsy (OBPP) patients showed with exercises when they were 3, 6, and 12 months old and to evaluate whether the exercise treatment given at different frequencies contributes to this recovery or not. METHODS: This study was designed as a randomized controlled trial. Sixty cases who were referred to Pediatric Rehabilitation and Pediatric Orthopedic Clinics with the diagnosis of having Groups I and II OBPP according to Narakas classification were included in the study. Subjects were randomly divided into two treatment groups. The first group had intense exercise program 3 times daily, and the second group had a standard exercise program once in a day. The subjects were assessed using a passive-active range of motion (ROM) and hospital for sick children muscle grading system at their first clinic visit and every month after until they became 12 months old. RESULTS: In both groups, a significant recovery was observed in ROM and muscle strength of all movements of the shoulder, elbow flexion, and forearm supination at the 3rd, 6th, and 12th-month reassessments, whereas a significant difference was not achieved on both parameters between two groups. CONCLUSION: According to the results, exercise frequency did not affect the recovery rate and results in the cases with OBPP and exercises were influential against possible complications that may occur

The effect of high-intensity versus low-level laser therapy in the management of plantar fasciitis: a randomized clinical trial

PubMed ID: 29627888We aimed to compare the efficacy of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) in the treatment of plantar fasciitis (PF). Seventy patients were randomized into either the LLLT (8 men, 27 women; mean age 48.65 ± 10.81 years) or HILT (7 men, 28 women; mean age 48.73 ± 11.41 years) groups. LLLT (904 nm) and HILT (1064 nm) were performed three times per week, over a period of 3 weeks. Each treatment combined with silicone insole and stretching exercises. Patients’ pain and functional status were evaluated with Visual Analog Scale, Heel Tenderness Index, and Foot and Ankle Outcome Score before and after treatment. A chi-square test was performed to compare demographic and clinical characteristics. Within-group and between-group differences were also investigated. Paired samples t test was used to analyze the differences between baseline and after treatment values, while independent samples t test was used to compare the two groups. Both groups contained similar demographic characteristics including age, sex, and body mass index (all p > 0.05). Three and two patients in the HILT and LLLT group, respectively, were lost to follow-up. At the study onset, there were no statistically significant differences between the two groups in the Visual Analog Scale, Heel Tenderness Index, and Foot And Ankle Outcome Scores. Three weeks later, both groups showed significant improvement in all parameters (p < 0.05). The HILT group demonstrated better improvement in all parameters than the LLLT group. Although both treatments improved the pain levels, function, and quality of life in patients with PF, HILT had a more significant effect than LLLT. © 2018, Springer-Verlag London Ltd., part of Springer Nature