Effect of estrogen and progesterone on nerve conduction studies during ovarian cycle

Objectives: This study aims to investigate the effects of estrogen and progesterone on nerve conduction studies (NCSs) in three different hormonal phases of the ovarian cycle. Patients and methods: Between April 2008 and July 2008, a total of 40 healthy volunteer women (mean age: 24.1 +/- 5.1 years; range 21 to 43 years) with regular menstrual cycles were included in this prospective study. The participants were regularly menstruating for at least one year, without any hormonal disease and without taking any medication that could lead to hormonal dysregulation. Motor and sensory conduction velocities, amplitudes, and distal latencies were analyzed at the dominant extremities within the early follicular phase (EFP), late follicular phase (LFP), and the midluteal phase (MLP). Results: Except for the median nerve motor conduction velocity (MCV), there were no statistically significant differences between the peripheral NCS results in the three ovarian cycle phases (p=0.033). After adjusting for multiple comparisons, a significant difference was found between the EFP and LFP (p=0.004). Conclusion: Our study results showed that only median nerve MCV was affected in the menstrual cycle. However, this would be an incidental finding, or an increased sensibility of the median nerve motor fibers to ovarian steroids by an unknown mechanism. Further studies are warranted

The comparision of the effectiveness of short wave diathermy and ultrasound in the treatment of gonarthrosis

Amaç: Gonartroz tanısı alan hastalarda fzik tedavi ajanlarından ultrason (US) ve kısa dalga diatermi (KDD) etkinliğini karşılaştırmak amaçlanmıştır. Gereç ve Yöntem: American College of Rheumatology (ACR) sınıfama kriterlerine göre gonartroz tanısı almış hastalar çalışmaya alındı. Diz bölgesinden cerrahi geçirmiş, travma geçirmiş, son 6 ay içinde diz içine enjeksiyon yapılmış, son bir yıl içinde fzik tedavi almış hastalar çalışmadan dışlandı. Hastalar iki gruba (KDD grubu ve US grubu) ayrıldı. Birinci gruba HP (20 dk), US (1.5 w/cm 2 , devamlı), TENS (20 dk), egzersiz uygulandı. İkinci gruba ise HP (20 dk), KDD (15 dk), TENS (20 dk), egzersiz programı uygulandı. Fizik tedavi programı haftada beş gün, toplam 15 seans olarak uygulandı. Tedavi öncesi ve sonrası fonksiyonelliği ve ağrıyı değerlendirmek için vizüel ağrı skalası (VAS) ve Western Ontario and MacMaster osteoarthritis index (WOMAC) kullanıldı. Bulgular: Çalışmaya toplam 132 hasta alındı, hastaların 63 tanesi KDD (%47,7), 69 tanesi US (%52,3) grubundaydı. Her iki grubun da tedavi öncesi ve tedavi sonrası VAS, WOMAC arasında istatistiksel anlamlı fark yoktu. Her iki grupta da VAS, WOMAC değerleri tedavi ile istatistiksel olarak anlamlı şekilde azalmıştır (tüm p<0,001). Sonuç: Bu çalışma ile uygulanan her iki fzik tedavi modalitesinin de gonartroz tedavisinde etkin olduğu ancak birbirlerine üstün olmadığı gösterilmiştir.Objective: To compare the effcacy of ultrasound (US) and short wave diathermy (SWD) in the gonarthrosis patients. Materials and Methods: Patients who had been diagnosed gonarthrosis according to American College of Rheumatology (ACR) classifcation criteria were included into the study. Patients who have undergone knee surgery, had trauma, had knee injection into the knee in the last six months, and had received physical therapy (PT) in the past year were excluded from the study. Patients were divided into two groups (US group and SWD group). HP (20 min), US (1.5 w/cm 2, continuous), TENS (20 min), exercise were administered to the frst group. HP (20 min), SWD (15 min), TENS (20 min), exercise were implemented to the second group. PT was administered for fve days a week, for 15 sessions in total. Visual analog scale (VAS) and Western Ontario and MacMaster osteoarthritis index (WOMAC) were used to assess function and pain before and after PT. Results: 132 patients were included into the study, 63 patients (47.7%) were in SWD group, and 69 patients (52.3%) were in US group. There were no statistically difference between the VAS, WOMAC values of the groups before and after PT. In both groups, VAS, WOMAC were scores statistically signifcantly decreased with treatment (all p&lt;0.001). Conclusion: This study showed that both these PT modalities are effective in treating the gonarthrosis, but not superior to each other

Horner Sendromu Tortikollis İlişkisi; bir Olgu Sunumu

Horner Sendromu, okülosempatik yolaktaki kesinti nedeniyle gözün sempatik innervasyon kaybı sonucu pitozis, miyozis, tek taraflı anhidrozis ve nadiren enoftalmus klinik semptomları ile karakterize nadir görünen bir klinik tablodur. Konjenital musküler tortikollis, sternokleidomastoid kasının fibrozisi ve buna bağlı kısalması ile oluşan bir kas iskelet sistemi malformasyonudur. Bu olgu sunumunda, konjenital musküler tortikollise ikincil gelişen horner sendromu ve bunun rehabilitasyon sürecindeki tanısı ele alınmıştır. Üç aylık bir kız bebek, konjenital musküler tortikollis tanısıyla, çocuk sağlığı ve hastalıkları polikliniği tarafından birimimize yönlendirildi. Öyküsünden, ikiz eşi olarak 34 haftalık gebelik sonrası sezaryen ile doğduğu, doğum sonrası yoğun bakım ihtiyacı olmadığı, ilk kez bir buçuk aylıkken ailesi tarafından boyunda asimetri fark edildiği ve çocuk sağlığı ve hastalıkları polikliniğine başvurduğu öğrenildi. Fizik muayenesinde kraniyofasiyal asimetri, servikal sol lateral fleksiyon, sola rotasyonda kısıtlılık ve olive belirtisi vardı. Rehabilitasyon sırasındaki takiplerinde yüzünün sağ yarısında anhidrozis, daha silik olarak sol tarafta miyozis ve pitozis bulguları da fark edilerek hastaya Horner Sendromu tanısı konuldu. Ayırıcı tanısı yapılarak olası diğer nedenler dışlandı ve etiyoloji hastadaki mevcut tortikollise bağlandı. Sonuç olarak hastalar tortikollis yönünden değerlendirilirken, nadir de olsa, tortikollise Horner Sendromu'nun eşlik edebileceği, klinik bulgular silik seyredebileceğinden tanının kolayca gözden kaçabileceği akılda tutulmalıdırHorner Syndrome is a rare condition characterized with ptosis, miosis, unilateral anhidrosis and rarely enophtalmos resulting from the sympathetic innervation loss by interruption of oculosymathetic pathway. Congenital muscular torticollis is a musculoskeletal system malformation resulting from fibrosis, therefore shortening of sternocleidomastoid muscle. In this report, Horner’s syndrome secondary to congenital muscular torticollis and diagnosis in rehabilitation period are discussed. Three-month-old baby girl was referred to our unit by pediatrics clinic with congenital muscular torticollis diagnosis. Her history comprised of cesarean delivery following a 34-week pregnancy as twin, and no intensive care need; her parents realized asymmetry in neck when she was a-month-anda-half old and they admitted to pediatrics. Craniofacial asymmetry, cervical left lateral flexion, restricted left rotation and olive sign were detected in physical examination. During rehabilitation, anhidrosis in the right side of face, soft left miosis and ptosis were also observed, and patient was diagnosed with Horner’s syndrome. Other possible reasons were ruled out with differential diagnosis and etiology was linked to torticollis. Consequently, while evaluating patients with torticollis, it must be considered that Horner’s syndrome, rarely accompanies, and since clinical findings may be soft, diagnosis may easily be missed ou

Sakroiliiti taklit eden hodgkin lenfoma: Olgu sunumu]

Musculoskeletal syndromes may be associated with neoplastic diseases. We hereby report a case of sacroiliitis that was diagnosed as Hodgkin's lymphoma during the follow-up process. Though sacroiliitis was confirmed with magnetic resonance imaging (MRI), a diagnosis of malignancy associated with sacroiliitis may be delayed and cause a clinical challenge. We aimed to discuss the presentation of lymphoma with sacroiliac joint involvement and its probable mechanisms and review the literature

Pelvik organ prolapsusu olan hastalarda el kavrama Gücünün Değerlendirilmesi]

Aim: Pelvic organ prolapse(POP) is a common condition that is observed in 50% of parous women. Weakness of pelvic floor muscles is an important factor that leads to POP. The hand grip strength is related to total muscle strength and it could be used to evaluate one's general muscle strength. The Jamar hand dynamometer is a portable dynamometer that uses a strain gauge to measure hand grip strength. We hypothesized that general muscle strength would be impaired in patients with POP. Material and Method: Twenty patients with pelvic organ prolapse and twenty-one controls were recruited from the gynecology clinic of Namik Kemal University School of Medicine. The POP-Q classification was used to quantify the clinical severity of the prolapse. Hand grip strength was measured using a JAMAR hydraulic hand dynamometer. Results: The median pelvic organ prolapse score was 3 (1-4) in prolapse group. The mean Jamar scores of both groups were similar for the right hand, the left hand and the dominant hand (p=0.774, p=0.575 and p=0.707, respectively). The mean body fat percentage was 33.9 +/- 5.7 % in prolapses group and it was 38.9 +/- 7.4% in control group (p=0.021). Discussion: We found no difference in terms of general muscle strength between POP group and healthy controls. Our results showed that Jamar scores, which represented general muscle strength of body, did not related to pelvic organ muscle strength

A rare localization of tuberculosis under infliximab treatment: Testicular involvement

Infliximab is an inhibitory of tumor necrosis factor-alpha which is used successfully for the treatment of inflammatory bowel disease and rheumatic disease. It has various side effects including injection-induced reactions, immunosuppression, demyelinating diseases, and cardiac effects. One of the most serious side effects is tuberculosis. In particular, the immunosuppressant drugs have a high risk of reactivating latent tuberculosis infection. Its activation probably may occur as an extra-pulmonary and, occasionally, may result in an unusual infection. Herein, we report a 30-year-old male case treated with infliximab and suffered from isolated testicular tuberculosis

Calprotectin levels in patients with rheumatoid arthritis to assess and association with exercise treatment

Rheumatoid arthritis (RA) is a chronic, inflammatory, and autoimmune disease that can cause permanent joint damage. In our study, we aim to analyze the change in calprotectin levels following the low-density exercise levels applied to the patients with RA. Twenty-eight patients with RA and 30 healthy controls were included in this study. To evaluate the activity of disease in RA, scores of disease activity that has increased (DAS-28) are figured. Calprotectin, nitric oxide (NO), white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and rheumatoid factor (RF) levels are tested as the laboratory evaluation. Calprotectin, NO, CRP, ESR, WBC, and RF levels were significantly higher in the patient group compared to the control group (p < 0.01, p < 0.001, p < 0.01, p < 0.01, p < 0.01, and p < 0.05, respectively). In correlation analysis applied to the patient group with RA, there has been determined a positive relation with calprotectin, and DAS-28, CRP, NO, RF, and WBC (p < 0.001, p < 0.05, p < 0.001, p < 0.05, and p < 0.05, respectively). In result of the low-density exercise treatment applied to patients with RA for 8 weeks, there has been determined a significant decrease in calprotectin, DAS-28, NO, CRP, ESR, and RF levels (p < 0.05, p < 0.001, p < 0.01, p < 0.05, p < 0.05, and p < 0.05, respectively). As a result, a significant relation is found between RA disease activity and calprotectin levels and other inflammatory parameters. At the same time, it shows that calprotectin which is a significant indicator of local inflammation can be used as a good identifier in following up exercise treatment

Psoriatic Arthritis Sine Psoriasis Presented with Nail and Joint Involvement: a Case Report

Psöriyatik artrit (PsA), periferal artrit, entezit, spondilit ve psöriyazis ile karakterize inflamatuarromatizmal bir hastalıktır. PsA’nın ortalama başlangıç yaşı 30-50 yaşları arasındadır. Klinikolarak, yaklaşık %15-17 hastada artrit, psöriyazisin başlangıcından daha önce gelişmektedir. Hastalarınbüyük bir çoğunluğunda ise psöriyazis, artritten önce gelişir. Özellikle distal interfalangealeklem tutulumu olan hastalarda beraberinde tırnak tutulumu da görülmektedir. Bazen tutulumdaktilit şeklinde olabilir ve bu bireylerde daha yıkıcı eklem hasarı gelişebilir. Nadiren de olsa eklemve tırnak tutulumu birlikteliği cilt lezyonu olmaksızın karşımıza çıkabilir. Bu yazıda, eklem ve tırnaktutulumu ile başlayıp cilt lezyonu olmaksızın devam eden psöriyatik artrit olgusu literatür eşliğindetartışılmaktadır.Psoriatic arthritis (PsA) is an inflammatory rheumatic disease characterized by peripheral arthritis, enthesit is, spondylitis and psoriasis. The average age of onset is between the ages of 30-50 in PsA. Clinically, approximately 15-17% of patients develop arthritis before the onset of psoriasis. In the majority of patients, psoriasis develops before arthritis. In particular, nail involvement is seen in patients with distal interphalangial joint involvement. Sometimes, this joint involvement may be in the form of dactilitis, and these individuals have more destructive joint damage. Rarely, joint and nail involvement may occur without skin lesion. In this article, we report a case of psoriatic arthritis that begins with joint and nail involvement without skin lesions and is discussed with the literature

The comparision of the effectiveness of short wave diathermy and ultrasound in the treatment of gonarthrosis

Amaç: Gonartroz tanısı alan hastalarda fzik tedavi ajanlarından ultrason (US) ve kısa dalga diatermi (KDD) etkinliğini karşılaştırmak amaçlanmıştır. Gereç ve Yöntem: American College of Rheumatology (ACR) sınıfama kriterlerine göre gonartroz tanısı almış hastalar çalışmaya alındı. Diz bölgesinden cerrahi geçirmiş, travma geçirmiş, son 6 ay içinde diz içine enjeksiyon yapılmış, son bir yıl içinde fzik tedavi almış hastalar çalışmadan dışlandı. Hastalar iki gruba (KDD grubu ve US grubu) ayrıldı. Birinci gruba HP (20 dk), US (1.5 w/cm 2 , devamlı), TENS (20 dk), egzersiz uygulandı. İkinci gruba ise HP (20 dk), KDD (15 dk), TENS (20 dk), egzersiz programı uygulandı. Fizik tedavi programı haftada beş gün, toplam 15 seans olarak uygulandı. Tedavi öncesi ve sonrası fonksiyonelliği ve ağrıyı değerlendirmek için vizüel ağrı skalası (VAS) ve Western Ontario and MacMaster osteoarthritis index (WOMAC) kullanıldı. Bulgular: Çalışmaya toplam 132 hasta alındı, hastaların 63 tanesi KDD (%47,7), 69 tanesi US (%52,3) grubundaydı. Her iki grubun da tedavi öncesi ve tedavi sonrası VAS, WOMAC arasında istatistiksel anlamlı fark yoktu. Her iki grupta da VAS, WOMAC değerleri tedavi ile istatistiksel olarak anlamlı şekilde azalmıştır (tüm p<0,001). Sonuç: Bu çalışma ile uygulanan her iki fzik tedavi modalitesinin de gonartroz tedavisinde etkin olduğu ancak birbirlerine üstün olmadığı gösterilmiştir.Objective: To compare the effcacy of ultrasound (US) and short wave diathermy (SWD) in the gonarthrosis patients. Materials and Methods: Patients who had been diagnosed gonarthrosis according to American College of Rheumatology (ACR) classifcation criteria were included into the study. Patients who have undergone knee surgery, had trauma, had knee injection into the knee in the last six months, and had received physical therapy (PT) in the past year were excluded from the study. Patients were divided into two groups (US group and SWD group). HP (20 min), US (1.5 w/cm 2, continuous), TENS (20 min), exercise were administered to the frst group. HP (20 min), SWD (15 min), TENS (20 min), exercise were implemented to the second group. PT was administered for fve days a week, for 15 sessions in total. Visual analog scale (VAS) and Western Ontario and MacMaster osteoarthritis index (WOMAC) were used to assess function and pain before and after PT. Results: 132 patients were included into the study, 63 patients (47.7%) were in SWD group, and 69 patients (52.3%) were in US group. There were no statistically difference between the VAS, WOMAC values of the groups before and after PT. In both groups, VAS, WOMAC were scores statistically signifcantly decreased with treatment (all p&lt;0.001). Conclusion: This study showed that both these PT modalities are effective in treating the gonarthrosis, but not superior to each other

The Role of pyhsical therapy modalities in the treatment of the carpal tunnel syndrome: a review of the literature

Karpal tünel sendromu (KTS), median sinirin el bileğinde karpal tünelde kompresyonu sonucu en sık görülen tuzak nöropatidir. KTSye neden olan birçok hastalık olmasına rağmen genellikle idiopatiktir. KTSnin tedavisinde konservatif yöntemler arasında; istirahat splintleri, steroid olmayan anti-infamatuvar ilaçlar, lokal steroid enjeksiyonu ve fzik tedavi yer alır. Fizik tedavi modaliteleri içinde literatürde en fazla ön plana çıkan terapötik ultrason ve düşük doz lazer tedavisidir. KTS, en iyi tanımlanmış ve üzerinde en çok araştırma yapılan tuzak nöropati olmasına rağmen, tedavide kullanılan bu yöntemlerin etkinlikleri ve birbirlerine üstünlükleri tartışmalıdır. Bu derlemede, KTS tedavisinde uygulanan konservatif tedavi seçenekleri arasından fzik tedavi modaliteleri ve bunların etkinlikleri incelenerek, etkin tedavi yöntemlerinin ortaya konması amaçlanmıştır. (Türk Osteoporoz Dergisi 2014;20: 125-31)Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by the compression of the median nerve at the wrist in the carpal canal. Although many diseases cause CTS, the etiology is usually idiopathic. There are various conservative treatment options including wrist splinting, nonsteroidal antiinfammatory drugs, local steroid injection and physical therapy modalities. The most prominent physical therapy modalities in the literature are therapeutic ultrasound and low-level laser therapy. Although CTS is the most well-defned and studied entrapment neuropathy, the effectiveness of the treatment modalities and superiority to each other is still controversial. In this review, the use of physical therapy modalities as the conservative treatment options of CTS are thoroughly examined and the mos