A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions. METHODS: Literature searches, completed in September 2015, were carried out in fourteen databases between years 1995 and 2015. The search results were independently screened by two reviewers. For the purpose of this manuscript, only randomized controlled trials which examined interventions using orthotic or prosthetic devices were selected for data extraction and synthesis. RESULTS: A total of 342 randomised controlled trials were identified (319 English language and 23 non-English language). Only 4 of these randomised controlled trials examined prosthetic interventions and the rest examined orthotic interventions. These orthotic interventions were categorised based on the medical conditions/injuries of the participants. From these studies, this review focused on the medical condition/injuries with the highest number of randomised controlled trials (osteoarthritis, fracture, stroke, carpal tunnel syndrome, plantar fasciitis, anterior cruciate ligament, diabetic foot, rheumatoid and juvenile idiopathic arthritis, ankle sprain, cerebral palsy, lateral epicondylitis and low back pain). The included articles were assessed for risk of bias using the Cochrane Risk of Bias tool. Details of the clinical population examined, the type of orthotic/prosthetic intervention, the comparator/s and the outcome measures were extracted. Effect sizes and odds ratios were calculated for all outcome measures, where possible. CONCLUSIONS: At present, for prosthetic and orthotic interventions, the scientific literature does not provide sufficient high quality research to allow strong conclusions on their effectiveness and cost-effectiveness

brief report

Insulin-like growth factor (IGF)-1, a mitogenic and anti-apoptotic peptide, can affect the proliferation of epithelial cells, and is thought to play a role in cancer development. The free IGF-1 represents the biologically active fraction of IGF-1. We hypothesised that there is a difference in free IGF-1 levels in the urine and serum from patients with TCC and normal subjects. Urine and blood samples were collected from 30 cases of superficial TCC and an equal number control subjects without malignancy. Free IGF-1 levels were measured in duplicate by radioimmunoassay. Specimens of bladder carcinoma were staged histopathologically using the Mostoffi grading system. Statistical analyses were performed using the Mann-Whitney U-test, Pearson correlation and covariate analysis. There was no significant difference in urine and serum free IGF-1 levels between the two groups. The correlation between urine and serum free IGF-1 levels and age was not significant. There was also no significant relationship between free IGF-1 levels and histopathological grading. The results of this pilot study reveal that the free IGF-1 level does not help predict tumour marker in the patients with bladder cancer

Clinical results of transurethral electrovaporization resection of prostate (TUVRP) with two different electrodes versus TURP: A randomized prospective clinical study [Prostatin Iki Farkli Elektrotla Yapilan Transüretral Elektrovaporizasyon Rezeksiyonu (TUVRP) ile TURP Kli?ik Sonuçlarinin Karşilaştirilmasi: Randomize Prospektif Kl·inik Bir Çalişma]

Introduction: The aim of our study was to compare the results of conventional transurethral electroresection of the prostate (TURP) and transurethral vaporization and resection of the prostate (TUVRP) operations in patients with symptomatic bladder outlet obstruction due to prostatic enlargement. Materials and Methods: 59 consecutive patients with symptomatic bladder outlet obstruction due to prostatic enlargement and prostate size between 20-60 g were prospectively randomized to two treatment groups; one group underwent standard TURP and the other TUVRP. Eligibility criteria included IPSS result 8 or grater, Qmax <15 ml/sec and prostate volume of 20 to 60 gm on transrectal ultrasonography. Patients less than 50 years old and those with a known neurogenic bladder, cancer of the prostate or bladder, history of prostate surgery or currently taking medications known to affect voiding function (alfa blockers) were excluded from this study. Patients were followed-up at 1, 3 and 12 months after treatment. International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-voiding residual urine volume (PVR) and transrectal ultrasound results were recorded during the follow-up period. Kruskal-Wallis variance analysis, Wilcoxon test and Bonferroni corrected Wilcoxon test was used for statistical analysis to compare the preoperative and postoperative data. Results: With respect to efficacy parameters (IPSS, Qmax, PVR and prostate volume) we did not observe statistically significant difference among those groups (TURP and TUVRP). Also the complications were similar on both groups. Conclusions: TUVRP seems to be a safe and efficacious modification of TURP (with) and the main advantage of this technique is to produce a more accurate TURP operation with less hemorrhage by improving surgeon's comfort during the resection

The awareness of physicians and allied health professionals about cardiopulmonary rehabilitation: A cross-sectional survey study [Kardiyopulmoner rehabilitasyon konusunda hekimler ve diger sagli{dotless}k çali{dotless}şanlari{dotless}ni{dotless}n farki{dotless}ndali{dotless}k düzeyi: Kesitsel bir anket çali{dotless}şmasi{dotless}]

Objective: Cardiopulmonary (CPR) programs were developed to improve and stabilize the physical, psychological, social, mental, professional, and economic conditions of patients with cardiovascular and pulmonary diseases. Although it is known that CPR reduces mortality and morbidity, it is not widely implemented as it is in Turkey. In this study, we aimed to determine the level of CPR awareness among physicians and allied health professionals. Material and Methods: This was a multi-center, cross-sectional survey study. The study included physicians, nurses, physiotherapists, and other allied health professionals who were informed about the survey and provided written consent to participate. Results: A total of 727 volunteers from 12 different centers were included in the study. Of the participants, 59.5% were physicians, 31.4% were nurses, 5.9% were physiotherapists, and 3.2% were other allied health professionals; 79.3% participants answered the question on if they have had any idea about CPR. Participants indicated that patients should be referred to cardiac pulmonary rehabilitation after a coronary artery bypass (83.8%), chronic obstructive pulmonary disease (83.2%), and cardiac valve surgery (38.9%). Only 40.1% of the survey participants provided information about CPR to patients, while 20.5% did not provide any information about CPR. Conclusion: This survey study determined that in centers where CPR could be implemented, health professionals have knowledge about CPR. If the study were conducted nationwide, the level of awareness might be even lower. Although it is an idea of CPR, the level of knowledge for this issue is not adequate. As the number of the CPR centers will increase, the knowledge of doctors and allied health professionals will advance. © 2014 by Turkish Society of Physical Medicine and Rehabilitation

Premenstrual syndrome and fibromyalgia: the frequency of the coexistence and their effects on quality of life

Objective: We aimed to investigate the association between Premenstrual syndrome (PMS) and fibromyalgia syndrome (FMS), to assess common symptoms and quality of life (QOL) of them.Methods: Patients with PMS formed the PMS group and age-matched healthy normal controls were included in the control group. The diagnosis of the FMS and PMS were based on new American College of Rheumatology FMS criteria and DSM-IV PMS criteria. FMS-related symptoms assessed by visual analog scale and number of tender points (TePs) were analyzed. QOL, PMS severity and FMS severity were assessed with SF-36, fibromyalgia impact questionnaire (FIQ) and premenstrual assessment form (PAF), respectively. Patients with PMS were divided into two subgroups according to coexistence of FMS or not.Results: The frequency of FMS in PMS and control group were 20 and 0%, respectively (p=0.002). FMS-related symptoms, number of TePs in the PMS group were higher than those in the control group. The mean mental component summary (MCS) score of SF-36 was low in the PMS group. The mean PAF score in PMS with FMS subgroup was higher than those in without FMS subgroup. The mean physical component summary of SF-36 was low in the PMS patient with FMS. There was correlation between PAF score and FIQ score (r=0.476, p<0.001).Conclusion: FMS was common among the patients with PMS and frequently seen in the PMS patients having severe premenstrual complaints. Mental QOL was distressed in the patients with PMS but while FMS accompanied to PMS, the physical QOL was decreased