74 research outputs found
SAPHO syndrome with adrenal deficiency: a case report
Introduction: The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteomyelitis) is a rare painful disorder, usually with a good long-term prognosis. Its etiology remains unclear, and various treatment regimens frequently fail to control the disease. Case presentation: A 46-year-old Caucasian female was referred for anterior chest wall and back pain. Physical examination was unremarkable except for skin lesions noted on soles of both feet, extremities and the face. A thoracic magnetic resonance imaging study demonstrated a lesion characterized with bone marrow edema and proliferation of soft tissue in the sternum. A brain MRI was requested secondary to the elevated prolactin level which was compatible with empty sella syndrome. Conclusion: The case presented here has the unique feature of adrenal deficiency presenting alongside the SAPHO syndrome and is presented as the first case reported. This syndrome could become complicated with different organ system involvement other than bone and skin. There is a need further studies that will explore the weak relationship between SAPHO syndrome and adrenal deficiency. © 2009 Eyigör et al.; licensee Cases Network Ltd
Diz osteoartriti olan yaşlı hastaların ev egzersiz tedavisine uyumu
Objectives: This study aims to evaluate the compliance to home-based exercise regimen by elderly patients with osteoarthritis of the knee.
Patients and methods: Between May 2012 and May 2013 year, a total of 72 patients (54 females, 18 males) over 65 years old with knee
osteoarthritis admitted to the Physical Medicine and Rehabilitation outpatient clinic were included in the study. The patients were given a
home-based exercise program. They were recommended to perform the exercises 10 times twice a day, for a month. We evaluated the patients’
demographic data, comorbid diseases, whether they exercised previously and compliance to exercise.
Results: All patients’ home exercise program compliance was 62.5%. Males were more compliant than female patients and high education
and comorbidity were also associated with poor compliance.
Conclusion: The compliance of the geriatric patients to home-based exercise program is difficult and multiple variables affect the compliance
LIMPRINT study - the Turkish experience
Background: Lymphedema and chronic oedema is a major healthcare problem in both developed and non-developed countries The LIMPRINT study is an international health service based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF).
Methods: 1051 patients from 8 centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools which assess the demographic and clinical properties as well as disability and QoL.
Results: Most of the Turkish patients were recruited from specialist lymphedema services and were found to be female, housewives and having secondary lymphedema due to cancer treatment. The duration of lymphedema was commonly less than 5 years and most of them had ISL Grade 2 lymphedema. Cellulitis, infection and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to Lymphedema centres nevertheless access seemed difficult due to distance and cost.
Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis and treatment in Turkey that utilise this informative data
Necessity of palliative care in the intensive care
The number of individuals with serious or life-threatening
diseases is gradually increasing because of the aging
population and technologies that enable longer life
expectancy. Palliative care programs are developed
in order to improve quality of life during the course of
these diseases. In palliative care, service is provided by
experienced and educated healthcare personnel and a
team of volunteers, and in hospital, first line treatment
environment, house or hospices, depending on the
conditions of each country. Intensive care units (ICUs)
are unique environments where patients with critical
condition receive rapid and aggressive life-saving
interventions. In developed countries physical therapy and
rehabilitation programs are integrated parts of intensive
care units in many hospitals. Considering patient needs
and complications in intensive care units, the importance
of improving patients’ quality of life emerges as an issue
to be kept in mind. Physical therapy and rehabilitation
programs aim to maintain optimum respiratory and
circulatory function in these patients, prevent muscular
atrophy, muscular problems and joint contractures,
control pain, optimize functioning and independency,
educate patients and enable the participation of the
caregiver. Physical therapy and rehabilitation specialists,
physiotherapists and occupational therapies work
together in a multidisciplinary palliative care team in
order to increase patients’ mobility, independency and
quality of life. Unfortunately it is observed that physical
therapy and rehabilitation programs are largely ignored
during the distribution of palliative care resources and
that necessary transfer of funds is not provided. In this
study we aim to highlight the role, necessity and benefit
of rehabilitation, one of the important components of
palliative care, in intensive care units.Yaşlanan popülasyon ve yaşam süresinin artmasını
sağlayan teknolojiler nedeniyle ciddi veya yaşamı
tehdit edici hastalıklara sahip bireylerin sayısı giderek
artmaktadır. Bu hastalıklar sırasında yaşam kalitesini
arttırmak için artan bir şekilde palyatif bakım programları
geliştirilmektedir. Palyatif bakımda hizmet, deneyimli
ve eğitimli sağlık personeli ve gönüllülerden oluşan
bir ekip tarafından sunulmakta ve her ülkenin kendi
koşulları içerisinde; hastane ortamında, birinci basamak
sağlık alanlarında, ev ortamında ve son dönem evleri
veya hospislerde verilmektedir. Yoğun bakım üniteleri,
kritik hastaların hızlı ve hayat kurtarıcı müdahaleler aldığı
özgün bakım ortamlarıdır. Fizik tedavi ve rehabilitasyon
programları gelişmiş ülkelerde pek çok hastanede yoğun
bakım ünitelerine entegre olmuş bir bölüm olarak yer
almaktadır. Yoğun bakım ünitelerinde hastaların ihtiyaçları
ve komplikasyonları göz önünde bulundurulduğunda,
bu hastaların yaşam kalitelerinin iyileştirilmesinin önemi
akılda tutulması geren bir durum olmalıdır. Fizik tedavi
ve rehabilitasyon programları ile hastalardaki optimum
respiratuar ve sirkulatuar fonksiyonun sürdürülmesi,
kas atrofisi ve kas kısalmasının, eklem kontraktürlerinin
önlenmesi, ağrının kontrol edilmesi ve giderilmesi,
fonksiyonun ve bağımsızlığın optimize hale getirilmesi,
hastaların eğitimi ve bakıcının katılımı hedeflenmektedir.
Fizik tedavi ve rehabilitasyon uzmanları, fizyoterapistler
ve iş-uğraşı terapistleri multidisipliner palyatif bakım
ekibi içerisinde hastaların mobilitesinin, bağımsızlığının
ve yaşam kalitesinin arttırılmasına yardımcı olmak
için birlikte çalışmaktadırlar. Maalesef palyatif bakım
kaynaklarının dağıtımı sırasında fizyoterapi ve
rehabilitasyon olasılıklarının yüksek oranda göz ardı
edilmekte olduğu ve gerekli kaynak aktarımının yeterince
yapılmadığı gözlenmektedir. Biz bu yazımızda palyatif
bakımın önemli bir bileşeni olan rehabilitasyonun, yoğun
bakım ünitesindeki rolünü, gerekliliğini ve sağladığı
faydanın vurgulanması amaçlamaktayız
Nöropatik ağrı açısından fibromyalji sendromu
Fibromyalgia Syndrome from the Perspective of Neuropathic Pain Fibromyalgia syndrome (FMS) is one of the several chronic pain syndromes and have been proposed to reflect some primary abnormality of the nervous system. Patients with FMS display common clinical features with neuropathic pain. the responsible mechanisms for symptoms and signs are still unknown. Mounting evidence was shown for central pain processing abnormalities in almost all FMS patients. These anomalies including hyperalgesia, allodynia, abnormal activation of pain-related brain regions and abnormal temporal summation of second pain in FMS patients strongly indicate a neuropathic pain syndrome. This new information led to the proposal that FMS may be a neuropathic pain syndrome maintained by central nervous system sensitization and sympathetic hyperactivity. This different perspective on FMS opens new avenues for research and treatment. in this review, a synthesis of the information about how FMS is related to neuropathic pain syndromes is provided.Klinik kullanımda lehte sonuçları olmasına rağmen, migren tedavisinde büyük oksipital sinir bloğunun (GON) etkisine dair az sayıda kanıt bulunmaktadır. Bir ön çalışmayla migren ataklarının önlenmesinde % 0,5 Fibromyalji sendromu (FMS), sinir sistemindeki primer anormalliklerin kliniğe yansıması ile karşımıza çıkan kronik ağrı sendromlarından biridir. FMS’lu hastalar, nöropatik ağrının yaygın klinik özelliklerini göstermektedirler. Bu semptom ve bulguları açıklayacak mekanizma halen anlaşılmış değildir. Santral ağrının hiperaljezi, allodini, ağrı ilişkili beyin bölgelerinin anormal aktivasyonu, anormal temporal sumasyon gibi nöropatik ağrı sendromu konusunda güçlü kanıtlara neden olan bir takım anormallikleri, FMS’lu hastaların çoğunda gözlenmektedir. Bu yeni bilgiler, santral sinir sisteminde sensitizasyon ve sempatik hiperaktiviteyle ilişkili, FMS’unun nöropatik ağrı sendromu olabileceğini düşündürmektedir. Bu farklı bakış açısı, tedavi ve çalışmalar için yeni kapılar açılmasına neden olmaktadır. Bu derlemede, FMS’unun nasıl nöropatik ağrı sendromu ile ilişkilendirildiğine dair bilgilerin sentezi yapılacaktır
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