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The aim of this study was to investigate the short- and long-term effects of Kinesio Taping (KT) and dry needling (DN) applications on pain, functionality, and muscle strength in patients with lateral epicondylitis by use of questionnaires and ultrasonography.Seventy-eight patients were randomized into 3 groups. Each group followed a program that consisted of 9 treatment sessions in total, with 3 sessions per week for 3 weeks. Group 1 received KT and performed exercise, group 2 received DN and performed exercise, and group 3 performed exercise alone. Pain, functional status, grip strength, and the thickness and echogenicity of the common extensor tendon were evaluated before treatment, after treatment (at the end of the third week), and after 6 months.In intragroup evaluations, KT and DN were found to be effective in the short and long term in terms of pain, functional status, muscle strength, and tendon thickness (P .01). In intergroup evaluations, improvement in the KT and DN groups was superior to that in the control group for all parameters (P .05). On comparison of the KT and DN groups, improvements in the clinical parameters and tendon thickness, heterogeneity, and elastography were significantly better in the DN group in the short and long term (P .05).The ultrasonographic outcomes in our study objectively demonstrated that although DN in general is superior in the treatment of lateral epicondylitis, KT treatment is also effective.

BACKGROUND To evaluate the role of the traditional risk scoring system (TRSS) in detecting subclinical atherosclerosis in HIV (+) patients. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Infectious Diseases Clinic, Izmir Katip Celebi University, Ataturk Training and Research Hospital, from March 2017 to January 2018. METHODOLOGY The patient group was formed with 52 HIV (+) patients, aged 18-60 years, and a control group was formed with 52 HIV (-) healthy volunteers. For all groups, there was no comorbid diseases or family history. Diabetes mellitus, hypertension, chronic kidney disease and cardiovascular disease were excluded from the two groups. Carotid intima-media thickness (CIMT) measurements were performed with high resolution B mode Doppler USG and patients with subclinical atherosclerosis were identified by the presence of atheroma plaque. RESULTS The median right CIMT measurement was 0.91 (0.73-0.97) mm and the median left CIMT was 0.90 (0.73-0.98) mm in HIV (+) patients. The median values of CIMT on right and left sides in the control group were 0.77 (0.67-0.81) mm and 0.76 (0.70-0.81) mm. Atheroma plaque was detected in 13.5% of the HIV (+) patients and in none of the control group. Subclinical atherosclerosis was found in 51.9% of HIV (+) patients and this rate was 7.7% in the HIV (-) group (p

Introduction: Diabetic foot is a chronic metabolic disease requiring a long duration of treatment and hospitalization in advanced stages. It requires a multidisciplinary approach to the different clinical presentations of the disease that complicate the process. In this study, the effects of serum chitinase-3-like protein 1 (YKL-40), pentraxin-3 (PTX-3), and neutrophil gelatinase-associated lipocalin (NGAL) levels on the prognosis of diabetic foot in different stages were evaluated. Subjects and Methods: A total of 65 patients with diabetes, and 13 healthy controls were included in the study. Wagner stage 0–1 patients were classified as mild disease (n = 26), Wagner stage 2–3 patients were classified as moderate disease (n = 26), and Wagner Stage 4 patients were classified as severe disease (n = 13). Venous blood was taken from the patients, and serum C-reactive protein, erythrocyte sedimentation rate, hemoglobin A1c, YKL-40, PTX-3, and NGAL levels were evaluated. In addition, the relationship between lower extremity vascular status and the markers was investigated. Results: YKL-40 was significantly higher in the severe disease group, PTX-3 was significantly higher in the moderate disease group, and NGAL was significantly higher in the mild disease group. In addition, YKL-40 and PTX-3 levels were found to be high in patients with arterial and venous insufficiency, but this was not observed for NGAL. Conclusions: High levels of serum YKL-40 are associated with advanced stage disease with atherosclerotic process at the forefront, high PTX-3 levels are associated with moderate stage disease with a high level of infection findings, and high NGAL levels are associated with the mild stage of diabetic foot.

Cavum vergae (CV) cysts are developmental cysts of the midline of the brain that is formed from the posterior extension of the cavum septum pellucidum. Several cases of enlarged CV have been reported previously, but prenatal diagnosis of this condition is very rare. We report a case of isolated dilated CV diagnosed prenatally. When midline intracranial cysts are determined prenatally, first physicians must pay attention to distinguish them from pathologic cyst and determine whether associated malformations are present or not. The sonography is a useful tool for both the differential diagnosis and identification of associated malformations. Although CV may be present as a normal variation without clinical findings, it has been also considered as a marker of impaired neurodevelopment. Although the relationship between the CV and the various clinical findings such as headache, papilla edema, cognitive and behavior disorders, and psychiatric problems has not been fully elucidated, an accurate evaluation will be helpful for estimation of prognosis, the assessment of the risk for the other related malformations, and for the follow-up of the patient. Also, it is important to identify these kinds of findings, to clarify their clinical importance and for genetic counseling.

Aim: The radiation can induce vessel injury. The result of this injury can be severe and life-threatening. There are a few studies demonstrating an increase in intima-media thickness (IMT) of the common carotid artery (CCA) after radiotherapy, especially in head and neck cancers. We evaluated the effect of I-131 to the IMT of the CCA in the patients who were treated for hyperthyroidism. Methods: 38 patients (25M, 13W) referred to our department for radioiodine treatment with the diagnosis of nodular goitre (25 patients) and diffuse hyperplasia (Graves disease (GD), 13 patients) were included to the prospective study. An USG was performed for all the patients before therapy, 3, 6 and 12 months after radioiodine therapy in order to measure IMT of CCA and the femoral artery (FA). The IMT was measured at the level of proximal part of bulbus anteriorly on the left and right side. The IMT of FA was measured just before the bifurcation. Results: There was a statistically significant increase in IMT of both CCA and FA bilaterally in nodular hyperthyroid patients. However, in the patients with Graves disease, there was only statistically significant increase in the left IMT of CCA at 0-3rd, 0-6th month measurements and in the right IMT of FA at 0-3rd month measurements. Conclusion: Though the limitation of the study is the interobserver and intraobserver variability, it was seen that I-131 therapy might affect the IMT of CCA in the patients with NG. I-131 effect on the IMT of CCA in patients with nodular goitre was higher than the IMT of CCA in patients with GD. I-131 effect on the IMT of CCA might be due to administered dose and adjacency. The interesting point of our study was the increased thickness of IMT in FA. We think that the increase in IMT is due to the systemic effect of radioactivity circulating in the blood vessel. I-131 effect on the IMT of FA in patients with nodular goitre was higher than the IMT of FA in the patients with GD due to I-131 uptake of thyroid gland. Because I-131 uptake was lower in patients with nodular goitre, I-131 in systemic circulation was higher. Conflict of interest:None declared.

In this study, we aimed to investigate the arterial and venous flow volume rate (FV) in order to determine the tissue perfusion using duplex ultrasonography (DU). We hypothesized that FV provides reliable information regarding tissue perfusion in patients with peripheral arterial disease (PAD).The study comprised 38 patients (72 legs) with PAD. In all patients, common femoral, popliteal, anterior tibial, posterior tibial arteries and veins were examined with DU. Measurements were obtained in the supine position with 15 cm elevation of the foot to neutralise central venous pressure. The diameter, blood flow velocity, and FV of arteries and veins were measured for each patient.The FV of the common femoral artery and vein (p = 0.001), popliteal artery and vein (p=0.003), and posterior tibial artery and vein (p = 0.008) had statistically significant differences. However, there was no statistically significant difference between the FV of the anterior tibial vein and artery (p = 0.408). The mean FV values of all veins were significantly lower than those of homonymous arteries in patients with PAD.Our study showed that venous FV measured by DU can be used as an indicator of impaired tissue perfusion in patients with PAD.

Summary Objectives: The aim of this study was to determine the prevalence of primary Sjogren’s syndrome (pSS) in a general Turkish population according to the latest proposed American–European Consensus Group (AECG) criteria and European-1 (EU-1) criteria. Methods: The study was conducted in two districts of Izmir and involved 2835 subjects 20 years of age and older. In the first stage, face-to-face interviews were performed at the registered households. In the second stage, subjects reporting symptoms of both dry eye and dry mouth were invited to the hospital for a full examination, which included Schirmer-1, sialometry and serologic tests. In the third stage, a minor salivary gland biopsy was performed as required. Results: A total of 2887 subjects were contacted and a complete interview was obtained for 2835 (1551 female, 1284 male) subjects. A total of 159 subjects (126 female, 33 male) confirmed oral and ocular dryness, and 86 of these patients (54.1%) underwent a detailed clinical examination in the hospital. pSS was diagnosed in 10 patients (nine females) according to the EU-1 criteria, and in six patients (six females) according to the AECG criteria. We found a minimum crude prevalence of 0.21% [95% confidence interval (CI): 0.03–0.29] in the sample population and an age–sex adjusted prevalence of 0.16% (95% CI: 0.06–0.35), according to AECG criteria. According to EU-1 criteria, these prevalence rates were found to be 0.35% (95% CI: 0.10–0.45) and 0.28% (95% CI: 0.13–0.51) respectively. Conclusion: The pSS prevalence rates found in the Turkish population in this study were lower than the estimated prevalence rate in a general population.

Objective: A positive relationship between epidermal growth factor receptor (EGFR) expression and radioresistance has been shown both in vitro and in vivo. In a group of 31 patients with early glottic cancer treated with definitive radiotherapy. the relationship of EGFR expression with patient and tumor related parameters were analyzed and the prognostic effect of EGFR expression on local control (LC) was assessed. Material and method: Between 1991 and 2001, 114 patients with early glottic (Tis-T2N0M0) squamous cell carcinoma were treated with radiotherapy at our institution. Among these, 31 patients whose pretreatment pathology specimens were available for immunohistochemical analysis formed the study population. Median age was 64 (46-77). Anterior commissure involvement was evident in 12 (38.7%) patients. Distribution according to T stage was as follows: Tis 6 (19.3%) T1 22 (71%), and T2 3 (9.7%). Histopathological grades of the 25 T1.2 tumors were 10/25 (40%) grade 1, 9/25 (36%) grade 2 and 6/25 (24%) grade 3. Our radiotherapy regimen was 66-70 Gy in 33-35 fractions over 6.5-7 weeks. The median follow-up period was 45 months (range. 5-116). Following immunohistochemical staining quantitative immunohistochemistry (IHC) was performed by image analysis software and stained tumoral area percentage (STAP) was identified. The cut-off value was 5%. The relationship of EGFR expression with patient (age) and tumor related (T stage, histopathological grade and anterior commissure involvement) parameters was evaluated using chi-square test. Prognostic significance of EGFR expression. age. T stage, histopathological grade, and anterior commissure involvement on LC was assessed using log-rank test. Results: No difference was found in EGFR content distribution in relation to age. T stage. histopathological grade, and anterior commissure involvement. In the univariate analysis including age (less than or equal to60 versus >60). T stage (Tis and T1 versus T2), histopathological grade (grade 1 and 2 versus grade 3), anterior commissure involvement (present versus absent), and EGFR expression (high versus low), only T stage and EGFR expression were found to be significant prognostic factors affecting LC (P = 0.0006 and P = 0.03. respectively). Conclusion: The results of this series support that EGFR expression is an unfavorable prognostic factor in early glottic carcinomas. For this reason EGFR IHC may be considered for selecting patients for more aggressive therapies (radiotherapy with different fractionation schemes or surgery) or enrollment into trials targeting EGFR signaling pathways. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

To determine the diagnostic performance of diffusion-weighted MRI and MR volumetry for the assessment of tumor response after preoperative chemoradiotherapy (CRT) in patients with locally advanced rectal cancer.Forty-three patients with rectal cancer who underwent preoperative CRT were prospectively examined for the study. This prospective study was approved by our institutional review board. DW- and high resolution T2-weighted imaging were performed before and after therapy. Two different diffusion gradients (b = 0 and b = 600, then separately b = 0 and b = 1000) were applied. The mean tumor volume and mean ADC values were measured before and after therapy. To evaluate the responders and nonresponders to neoadjuvant CRT, two criteria, ypT stage determined in the pathologic examination after treatment and histopathologic tumor regression grade (Ryan), were used as reference standards. The patients with a lower ypT stage than T stage in the first MRI before neoadjuvant CRT were evaluated as the responder group, while the patients with a higher or the same ypT stage relative to the first MRI T stage were evaluated as the nonresponder group. According to Ryan tumor regression grade, grade 1 was evaluated as the responders, whereas grades 2 and 3 were evaluated as the nonresponder group. The percentage ADC increase and percentage tumor volume regression were compared between the responders and nonresponders using two reference standards: T downstaging and tumor regression grade (TRG).Before CRT, the mean tumor ADC in the responder group was significantly lower than that in the nonresponder group (p0.001). At the end of CRT, the mean percentage of tumor ADC change in the responder group was significantly higher than that in the nonresponder group. The percentage tumor volume regression of the responders was significantly higher than that of the nonresponders (p = 0.001). The cut-off ADC value for discriminating between the responders and nonresponders after treatment was determined to be (b = 600) 1.03 × 10(-3)mm(2)/s and the sensitivity, 71%; specificity, 79%; accuracy, 74%; positive predictive value, 81%; negative predictive value, 68% respectively. The cut-off value for discriminating between the responders and the nonresponders after treatment was determined for b = 1000 as 1.20 × 10(-3)mm(2)/s and the sensitivity, 42%; specificity, 84%; accuracy, 60%; positive predictive value, 77%; negative predictive value, 53%.The increase in the mean tumor ADC and percentage tumor volume regression in patients with rectal cancer treated with preoperative CRT was correlated with good response. DW MR imaging is a promising non-invasive technique that can help predict and monitor early therapeutic response in patients with rectal cancer who undergo CRT.

We evaluated the relationship between the baseline sacroiliac joint (SIJ) magnetic resonance imaging (MRI) findings and the development of radiographic sacroiliitis and tested their prognostic significance in cases of ankylosing spondylitis. Patients who had undergone an SIJ MRI at the rheumatology department were identified. Individuals for whom pelvic X-rays were available after at least 1 year of MRI were included in the analysis. All radiographs and MRI examinations were scored by two independent readers. Medical records of the patients were reviewed to obtain potentially relevant demographic and clinical data. We identified 1,069 SIJ MRIs, and 328 fulfilled our inclusion criteria. Reliability analysis revealed moderate to good inter- and intra-observer agreement. On presentation data, 14 cases were excluded because they had unequivocal radiographic sacroiliitis at baseline. After a mean of 34.8 months of follow-up, 24 patients developed radiographic sacroiliitis. The presence of active sacroiliitis (odds ratio (OR) 15.1) and structural lesions on MRI (OR 8.3), male sex (OR 4.7), fulfillment of Calin’s inflammatory back pain criteria (P = 0.001), and total MRI activity score (P

Carcinosarcomas are rare biphasic malignant neoplasms with an epithelial and a spindle cell component. We present a 62-year-old man with a history of noticeably abdominal distension, proved by surgery to be caused by carcinosarcoma of the renal pelvis and urinary bladder, occupying the entire left abdominal flank. We also illustrate the appearance of this rare entity on sonography and computed tomography.