To What Extent Can Adolescent Scoliosis Be Improved in Four Weeks?

Scoliosis is a condition that leads to severe disability and an impaired cosmetic appearance in adolescence. This article presents x-ray images of a patient with adolescent idiopathic scoliosis (AIS) in whom the pain and posture improved dramatically over four weeks, emphasizing the importance of physical therapy. A 13-year-old male was admitted because of posture deformity and mild back and lower back pain. He was being followed with the diagnosis of scoliosis for two years and specific exercises were proposed for scoliosis. On physical examination, we observed paravertebral muscle spasm and significant asymmetry of the thoracolumbar region. Neurological examination and laboratory tests were normal. X-ray showed arcuate thoracolumbar scoliosis (cobb angle: 24°) with a leftward convexity. Electrical stimulation was applied to the convex and concave sides for 30 minutes, five times a week for four weeks and an exercise program was performed under the supervision of a therapist. The stimulation amplitude was the maximum stimulation intensity with which the patient was comfortable. Analgesic and myorelaxant drugs were not required, and no brace was used. After the treatment, significant improvements were observed in the patient’s posture and radiography (cobb angle: 10°). This work demonstrates that well-planned physical therapy is a rapid and effective option for treating AIS

The Role of Acromioplasty in the Treatment of Shoulder Impingement Syndrome Acromioplasty in the Treatment of Shoulder Impingement

Aim: The results of open acromioplasty procedures were investigated for shoulder impingement syndrome in patients who did not respond to conservative treatment. Methods: Twenty cases of shoulder impingement syndrome who did not respond to conservative treatment were investigated prospectively. The shoulder abduction and flexion range of motion and muscle power were measured preoperatively and postoperatively. Anteroposterior, neutral, axillary and impingement radiographs were taken. Shoulder magnetic resonance imaging (MRI) was performed. Clinical assessment was performed by the Constant shoulder score. Results: Results of MRI revealed that 20 cases had type 1, 2 and 3 acromion in 3, 9 and 8 patients, respectively. The mean followup time was 16 months. Compared to preoperative conditions, the results in 80% of cases were rated as perfect (p<0.000), since all cases had gained both significantly more range of motion (p<0.000) and muscle power (p<0.000), in addition to decreased pain in all cases (p<0.000). Four cases who had been rated as good had common features as advance age, traumatic etiology and inadequate rehabilitation. Conclusion: Open acromioplasty surgery reduces pain, increases range of motion and is an effective treatment option in cases of shoulder impingement syndrome not responding to conservative treatment. (The Me di cal Bul le tin of Ha se ki 2011; 49: 141-4

Adolesan skolyoz dört haftada ne kadar iyileştirilebilir?

Scoliosis is a condition that leads to severe disability and an impaired cosmetic appearance in adolescence. This article presents x-ray images of a patient with adolescent idiopathic scoliosis (AIS) in whom the pain and posture improved dramatically over four weeks, emphasizing the importance of physical therapy. A 13-year-old male was admitted because of posture deformity and mild back and lower back pain. He was being followed with the diagnosis of scoliosis for two years and specific exercises were proposed for scoliosis. On physical examination, we observed paravertebral muscle spasm and significant asymmetry of the thoracolumbar region. Neurological examination and laboratory tests were normal. X-ray showed arcuate thoracolumbar scoliosis (cobb angle: 24&deg;) with a leftward convexity. Electrical stimulation was applied to the convex and concave sides for 30 minutes, five times a week for four weeks and an exercise program was performed under the supervision of a therapist. The stimulation amplitude was the maximum stimulation intensity with which the patient was comfortable. Analgesic and myorelaxant drugs were not required, and no brace was used. After the treatment, significant improvements were observed in the patient's posture and radiography (cobb angle: 10&deg;). This work demonstrates that well-planned physical therapy is a rapid and effective option for treating AIS.Skolyoz, adolesan dönemde ağır özürlülüğe ve kozmetik bozukluğa neden olabilen bir durumdur. Bu yazıda fizik tedavi uygulamalarının önemini vurgulamak için, adolesan idiyopatik skolyozu olan ve dört haftada belirgin iyileşme gösteren bir olgu grafileri ile birlikte sunulmuştur. On üç yaşındaki erkek hastamızın duruş bozukluğu ve hafif bel ağrısı şikayeti bulunmaktaydı. Hastamız iki yıldır skolyoz tanısıyla takip edilmekteydi ve hastaya skolyoza özel egzersizler önerilmişti. Fizik muayenede paravertebral kas spazmı ve belirgin torakolomber asimetrisi vardı. Nörolojik muayene ve laboratuvar testleri normaldi. X-ray grafisinde konveksitesi sola bakan torakolomber skolyozu (cobb açısı: 24°) tespit edildi. Hastaya haftada beş gün, dört hafta boyunca elektrik stimülasyonu (konveks ve konkav tarafa eş zamanlı olarak 30 dakika süre ile) ve terapist eşliğinde egzersiz programı uygulandı. Stimülasyonun amplitüdü hastanın rahatsızlık duymayacağı maksimum uyarı şiddetindeydi. Analjezik ve miyorelaksan ilaç ihtiyacı olmadı ve breys kullanılmadı. Tedavi sonunda yapılan değerlendirmede hastanın postüründe ve radyografisinde belirgin düzelme elde edildi (cobb açısı: 10°). Sonuç olarak, bu olgu iyi planlanmış fizik tedavi programının adolesan idiyopatik skolyoz tedavisinde hızlı ve etkin bir seçenek olduğunu göstermektedir.Anahtar­ Sözcükler:­ Elektrik stimülasyonu, egzersiz tedavisi, skolyoz

Screening of hand and foot anomalies in schoolchildren of Fatih district, Istanbul city

Giriş: İstanbul ili Fatih ilçesi okul çocuklarında el ve ayak anomalileri taraması amaçlandı. Gereç ve Yöntem: 2008-2009 akademik yılında 41 okul arasından rastgele seçilen 6 okulda, 4259 çocuk tarandı. Taranan çocukların %51,7’si erkek, %48,2’si kızdı. Tüm çocukların el ve ayak muayeneleri yapıldı, anomaliler, cinsiyet ve yaşları kaydedildi. Bulgular: Taranan çocuklarda görülen el ve ayak anomalileri sıklığı %10,7 bulundu. Ensık görülen anomali %9,7 ile pes planus olurken, ikinci sıklıkta ‰5,64 ile halluks valgus görülmekteydi. En sık görülen el anomalileri ise %0,7 sıklık ile Kirner deformitesi ve klinodaktiliydi. Sonuç: Temel sağlık hizmetlerinin daha iyi planlanması ve daha iyi sağlık hizmeti sunulabilmesi için bu tip çalışmaların daha fazla yapılması gerektiği kanaatindeyiz.Objectives: The aim was screening of the hand and foot anomalies in children of Fatih district, Istanbul city. Material and Methods: In the 2008-2009 academic year, 4259 students were screened in six schools which were chosen randomly from a total of 41 schools. The study population consisted of 51.7% boys and 48.3% girls. Hand and foot examination was performed and anomalies, gender, and age were recorded. Results: The hand and foot anomaly frequency was found 10.7%. The most frequent anomaly was pes planus with an incidence of 9.7% and the second anomaly was hallux valgus with an incidence of 5.64‰. The most frequent hand anomaly was Kirner deformity and clinodactyly with an incidence of 0.7% each. Conclusion: We advice that more epidemiological studies should be performed for planning and providing better healthcare services

Assessing the negative impact of phenyl alkanoic acid derivative, a frequently prescribed drug for the suppression of pain and inflammation, on the differentiation and proliferation of chondrocytes

WOS: 000379205000001PubMed ID: 27363505Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed to relieve pain and inflammation. These NSAIDs have also analgesic effects and can be administered via oral, injectable, and topical routes. During inflammation, a number of synovial mediators and cytokines are released which decrease the pH level of the synovial fluid. Administration of acidic NSAIDs further decreases the pH levels and hence contributes to the destruction of the cartilage. To our knowledge, no cellular-based study regarding the chondrotoxicity of phenyl alkanoic acid derivatives on NSAIDs was conducted before. Thus, the aim of this pioneering study was to examine the effect of frequently prescribed NSAIDs, a phenyl alkanoic acid derivative, flurbiprofen, on the proliferation and differentiation of human primer chondrocyte cultures in vitro. Methods: Primer chondrocyte cultures were prepared from osteochondral tissue obtained during surgery for gonarthrosis. Samples not exposed to the pharmacological agent were used as the control group. The samples were treated with 1, 10, 100, 250, 500, or 1000 mu M of the agent for 24, 48, and 72 h. The cell viability, toxicity, and proliferation were assessed with MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) analysis and prechondrocytic precursor stage-specific embryonic antigen-1 (SSEA-1) expression using a commercial ELISA kit spectrophotometrically. The surface morphology of the samples in each group was compared using an inverted light microscope and an environmental scanning electron microscope (ESEM). An analysis of variance was used to compare between-group differences. Tukey's honest significant difference (HSD) method (95 % confidence interval) was used to evaluate the differences and significance in averages. The alpha significance value was considered < 0.01. Results: Statistically significant cytotoxicity was observed in the treatment groups. NSAID had a significant negative effect on the proliferation and differentiation of chondrocytes as compared to the control group (p < 0.01). Conclusion: Before administering phenyl alkanoic acid derivatives in the clinical setting, their role in suppressing the proliferation and differentiation of chondrocytes should be taken into account. Thus, caution should be given when prescribing these drugs

Adölesan idiyopatik skolyozda cerrahi sonrası omuz dengesizliğinin hastanın tedaviden memnuniyeti üzerine etkisi

Objective: We aimed to evaluate whether there is a relation between the level of shoulder imbalance after scoliosis surgery and patients' satisfaction with treatment. Materials and methods: Twenty-three patients with adolescent idiopathic scoliosis (18 females, 5 males; mean age, 15.9 years; age range, 13-24 years), who were treated by posterior instrumentation and fusion and followed up for an average of 35.4 months (range, 24-67 months) postoperatively, were included in this retrospective clinical study. In order to evaluated shoulder balance on coronal plane, three parameters were measured on postoperative radiography: first rib angle, radiographical shoulder height, and clavicle angle. For the assessment of patients' satisfaction with scoliosis surgery, Scoliosis Research Society (SRS)-22r Patient Questionnaire was used.Results: Fusion was obtained in all patients. On radiography, mean first rib angle was 2.5&ordm;&plusmn;2.8&ordm;, shoulder height was 6.0&plusmn;5.4 mm, and clavicle angle was 1.7&ordm; &plusmn; 1.5&ordm;. The mean values for SRS22r domain scores were between 3.3 and 3.8, being lowest for mental health and highest for pain and self-image. There was no significant correlation between radiographic parameters and total or domain scores of SRS-22r.Conclusions: Shoulder imbalance is a common undesirable effect of correcting thoracic curve in surgical treatment of adolescent idiopathic scoliosis. However, unless it is severe, shoulder imbalance does not cause patient dissatisfaction.Amaç: Bu çalışmada skolyoz cerrahisi sonrası oluşan omuz dengesizliğinin düzeyi ile hastaların tedaviden memnuniyeti arasında bir ilişki olup olmadığını değerlendirmeyi amaçladık. Materyal-Metod: Bu retrospektif klinik çalışmaya, posterior enstrümentasyon ve füzyon ile tedavi edilen ve cerrahi sonrası ortalama 35.4 ay (aralık, 24-67 ay) izlenen 23 adölesan idiyopatik skolyoz hastası (18 kadın, 5 erkek; ortalama yaş, 15.9 yıl; yaş aralığı, 13-24 yıl) dahil edildi. Koronal düzlemde omuz dengesini değerlendirmek için, posoperatif radyografide üç parametre ölçüldü: ilk kaburga açısı, radyografik omuz yüksekliği ve klavikula açısı. Hastaların skolyoz cerrahisinden memnuniyetlerini değerlendirmek için, Skolyoz Araştırma Derneği (SRS)-22r Hasta Anketi kullanıldı.Bulgular: Tüm hastalarda füzyon sağlanmıştr. Radyografide ortalama ilk kaburga açısı 2.5º±2.8º, omuz yüksekliği 6.0±5.4 mm ve klavikula açısı 1.7º±1.5º ölçülmüştür. Ortalama SRS-22r domain skorları 3.3 ile 3.8, arasında değişirken, en düşük skor mental sağlık, en yüksek skor ise ağrı ve kendi imaj/görüşü için kaydedilmiştir. Radyografik parametreler ile SRS-22r toplam ve domain skorları arasında anlamlı korelasyon bulunamamıştır.Sonuç: Adölesan idiyopatik skolyozda cerrahisinde torasik eğriliğin düzeltilmesinin sıkça rastlanan istenmeyen etkisi omuz dengesizliğidir. Ancak bu dengesizlik şiddetli olmadığı sürece, hastalarda tedaviden memnuniyetsizliğe neden olmaz