Search

Aims: Permanent treatment of morbid obesity with medication or diet is nearly impossible. Laparoscopic sleeve gastrectomy (LSG) is becoming a widely accepted treatment option. This study profiled and compared gut microbiota composition before and after LSG. Methods & results: A total of 54 stool samples were collected from 27 morbidly obese individuals before and after LSG. The gut microbiota was profiled with 16S amplicon sequencing. After LSG, patients demonstrated a significant decrease (p

Background/aim: Reducing lymphedema-associated burden and disability in the pediatric setting requires improved awareness and understanding clinical properties of the lymphedema. The aim of this study was to evaluate the clinical and demographic characteristics of patients with pediatric lymphedema presented to different lymphedema centers in Turkey. Materials and methods: The socio-demographic and clinical characteristics of the children including age, gender, presence of genetic syndromes, duration of edema, site and stage of lymphedema and the received therapies were determined. Parental and children education on self-management techniques were recorded. Results: A total of 122 children (female: 66, male: 56) with a mean age of 120.7 +/- 71.2 months were included from 7 centers. Of them; 92% had primary, 8% had secondary lymphedema mostly due to infection and trauma. Lymphedema was part of a syndrome in 18% of the children. The most common site of involvement was the lower extremity, followed by upper extremity and genital involvement. Lymphedema was complicated in 17 % of children, mainly with a clinical picture of cellulitis, infection, and pain. The median duration of lymphedema was 41 (5-216) months. Although most of the children had stage 2 lymphedema, only 40% of them received treatment. The most commonly received treatment was compression therapy. No family or child was educated for self-care management before. Conclusion: In conclusion, pediatric lymphedema has a comparable gender distribution and usually involves the lower extremities. Although most of the children had advanced disease, more than half of the patients did not receive any treatment indicating the unmet need for management of lymphedema. The education of patients and/or children about self-management methods were lacking. We suggest educational activities for both families of children with lymphedema and health care providers, in order to facilitate early reference to lymphedema units and to receive prompt preventive and therapeutic approaches for this suffering condition.

Şahin, Nilay (Balikesir Author), Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. Patients and methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital AnxietyDepression Scale [HADS]) were recorded. Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p

Purpose: This study aimed to determine the differences in the levels of physical activity and healthy lifestyle behaviors in elderly individuals living in urban and rural and to examine their relationship with depression. Material and Methods: Individuals who are over >65 years old and residing in the city and rural were included in the study. The Healthy Lifestyle Behaviors Scale-II, the Physical Activity Scale for the Elderly, and the Geriatric Depression Scale-15 were used on the participants. Results: Healthy Lifestyle Behaviors Scale-II scores were not significantly different between the two groups (p=0.430). Physical Activity Scale for the Elderly score in rural (p= 0.001); Geriatric Depression Scale-15 score were statistically higher in the city group (p= 0.01). While the relationship between the Healthy Lifestyle Behaviors Scale-II and Geriatric Depression Scale-15 scores was significant in both groups (p= 0.001 and p= 0.03), the relationship between the Elderly Physical Activity Scale-II and Geriatric Depression Scale-15 scores was significant only in the rural group (p= 0.001). Conclusion: The elderly individuals in rural are more physically active than in the city, and the elderly living in the city have higher depression levels. This current study suggests that the difference in depression scale scores of individuals living in the city center and rural areas may be due to the difference in physical activity scores. The factors affecting depression in the elderly living in cities need to be examined in detail.

Aim: The aim of this study was to determine the change in serum vitamin and trace element levels of patients undergoing laparoscopic sleeve gastrectomy (LSG), which is one of the bariatric surgery ...

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.

In the prospective, randomized, controlled multicenter study, 100 patients who were clinically diagnosed with sarcopenia were assigned to either a home-based exercise group or a control group. The home-based training program included exercises with gradually increasing intensity comprising posture, stretching and upper- and lower-extremity muscle-strengthening exercises, balance and coordination exercises, and gait training. Before and 3 months after the exercise program, all the patients were evaluated. The 6-min walking test and Berg Balance Scale scores increased significantly after 3 months in the home-based exercise group compared with the controls. There was also a significant decrease in timed up and go test scores and a significant improvement in quality of life in the exercise group compared with the control group. Our findings indicated that a home-based exercise program can have a positive effect on physical function, balance, and quality of life in patients with sarcopenia.

Objectives: In this study, we aimed to investigate the availability of the Timed Up and Go (TUG) test in daily practice instead of the Tampa Scale for Kinesiophobia (TSK) test for the evaluation of fear of movement and to assess the functionality of the upper extremity in postmastectomy lymphedema patients. Patients and methods: Between March 2018 and July 2018, a total of 30 female patients (mean age 53.8±12.3 years; range, 35 to 80 years) with postmastectomy lymphedema were included in this study. The severity of lymphedema of the patients was measured circumferentially at 5-cm intervals. All patients were evaluated for upper extremity functionality using the Timed Functional Arm and Shoulder Test, hand grip strength using a hand dynamometer, and pinch strength using a pinchmeter. The TSK test was used for the evaluation of fear of movement and TUG test was used for the evaluation of functional status of lower extremity. Results: There was a significant difference in functionality between the affected and unaffected side of upper extremity (p

Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).

Chronic pelvic pain is defined as persistent painful condition which lasts for at least six months under umbilicus. Numerous factors are blamed for etiopathogenesis, and quality of life of individuals is adversely affected. Chronic pain as well as functional disorders are accompanied to chronic pelvic pain. The treatment and rehabilitation program should be tailored for specific causes, targeting general pain treatment. Consequently, chronic pelvic pain management can be used to propose personalized treatment options and include patient education, behavioral therapy, and a biopsychosocial approach. Interdisciplinary teamwork and collaboration are essential for facilitating patient-centered rehabilitation.

Aim: Coccydynia refers to pain originating from the coccyx, or tailbone.It is aimed to investigate the coexistence of coccydynia with hemorrhoid which is similar afflictions in the same region. Material and Methods: Thirty-seven patients who had hemorrhoids at the end of the physical examination evaluations of eighty-seven coccydynia patients were included in this study. Patients with hemorrhoids were divided into two groups: those with external hemorrhoids (Group 1) and those with internal hemorrhoids (Group 2). The demographic characteristics were recorded and pain assessment of the cases were compared with the numerical rating scale (NRS) during the sitting and standing periods. P 0.05), NRS in Group 1 (5.83±3.51), Group 2 (2.28±1.59) were found statistically significant (p

Sacral insufficiency fracture (SIF) is an uncommon cause of hip and back pain. Sacroiliitis, often a feature of inflammatory conditions of spinal column, is inflammation of sacroiliac joints. Herein, we report a 41-year-old woman presenting with a SIF and sacroiliitis as a part of non-radiographic axial spondyloarthritis.

Our aim was to evaluate the feasibility of using shear wave elastography (SWE) to assess first extensor compartment tendons rigidity and its alterations with tenosynovitis.We performed B-mode ultrasound and SWE to total number of 80 participants. All participants were evaluated clinically to call the diagnosis of de Quervain tenosynovitis or to rule out the diagnosis. We composed 2 groups. Group 1 included 40 healthy volunteers (33 females and 7 male participants with ages ranging from 24 to 60 years, median age was 37.5 years) and group 2 had 40 de Quervain patients (32 females and 8 male patients with ages ranging from 25 to 51 years, median age was 34 years). SWE measurements were repeated 3 times and arithmetic average was used for the final SWE value.The median SWE value of healthy group (group 1) was 72kPa and the de Quervain patient group (group 2) was 29kPa. Two groups demonstrated statistically significant difference (p0.001). The ROC curve analysis was performed and the SWE value of 40.5kPA was calculated as a cut-off value for the diagnosis of de Quervain tenosynovitis with 95% specificity and 85% sensitivity.SWE modality can provide useful data regarding de Quervain tenosynovitis.

Aim The aim of this study was to compare the effects of urinary incontinence (UI) and subtypes, including urinary stress incontinence (USI), urinary urge incontinence (UUI), and urinary mixed incontinence (UMI), on sexual function and quality of life (QoL) of women. Methods Sexually active premenopausal consecutive women (n = 153) with UI were enrolled in this study. Sexual function was assessed with the Golombok–Rust Inventory of Sexual Satisfaction (GRISS), and QoL was assessed with the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form. Results The patient population (n = 153) was composed of women with USI (n = 20), UUI (n = 21), UMI (n = 40), and a control group (n = 72) assessed for only routine gynecological evaluation. Infrequency, dissatisfaction, avoidance, and anorgasmia were significantly higher in the UI group compared to the control group (P

Objective: Patients with fibromyalgia syndrome (FMS) have mild cognitive dysfunction. Higher serum uric acid (UA) levels in some diseases are reported to be associated with cognitive impairment. Mean platelet volume (MPV) is an indicator of platelet activation. Activated platelets may play a role in neuroinflammation and cognitive dysfunction. The purpose of this study was to compare cognitive functions of FMS patients and controls and investigate the relation of serum UA and MPV levels with cognitive functions. Method: Fifty-four patients with FMS and 33 healthy controls were enrolled,retrospectively. Evaluations were performed with Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory(BDI) and to asses phychological status and cognitive impairment Mini Mental State Examination(MMSE) was used in both groups. Results: Mean VAS and sleep quality of FMS group were significantly higher than the control group (p0.05). No significant correlation was found between serum MPV levels and VAS pain/ sleep quality, FIQ, BDI and MMSE scores (p>0.05) but declined cognitive functions were determined in the FMS group when compared with the control group. Conclusion: Declined cognitive functions were determined in the FMS the FMS group when compared with the control group. Although we did not determine an association of serum uric acid and MPV levels with cognitive functions, larger prospective studies with longer follow up periods are warranted to elucidate the role of these biomarkers in FMS and to determine the factors affecting cognitive functions.

Background/aim s1-Selective beta-blockers (BBs) are sympatholytic agents, and discerning their effects on bone health would be of great importance. This study aimed to investigate the influence of s1-Selective BBs on bone mineral density (BMD) and fracture risk. Materials and methods This study included postmenopausal women who used s1-selective BBs (BB group) and control group. Sociodemographic characteristics, BMD and previous fragility fractures were recorded. Additionally, the 10-year probability of a major osteoporotic and hip fracture was calculated using the Fracture Risk Assessment Tool (FRAX). Results A total of 60 participants were included in the study. L1 - 4 and L2 - 4 BMD values were significantly higher in BB group than control group (p = 0.015 and p = 0.025, respectively). Moreover, T-scores of lumbar and femur total were significantly higher in the BB group. Two patients in BB and six patients in control group had previous fragility fracture. No statistically significant intergroup difference was noted regarding FRAX. Conclusion Based on our results, s1-selective BB usage was associated with higher BMD at the lumbar region in postmenopausal women.

De Quervain tenosynovitis affects the first extensor compartment of the wrist and occurs more frequently in females. This high prevalence could not be explained by soft tissue. As the osseous anatomy has been mostly neglected, we aimed to compare the distal radius between the sexes. We evaluated the presence of a bony ridge on the floor of the first extensor compartment on CT images with multiplanar imaging. We included 244 wrists (72 females, 172 males) in the study. A bony ridge was present in 58 (23.8 %) and absent in 186 (76.2 %) wrists. A ridge was present in 24 (33.3 %) wrists among females and 34 (19.8 %) wrists among males. A groove with a bony ridge was statistically associated with females. We observed two tendon groove morphologies for the first extensor compartment. A groove with a bony ridge occurs more frequently in females. Further research is needed to clarify the relationship between the high frequency of a bony ridge and increased prevalence of de Quervain tenosynovitis in females.

Sen, Ekin Ilke/0000-0002-6489-3368; karahan, ali yavuz/0000-0001-8142-913X; Akaltun, Mazlum Serdar/0000-0002-9666-9483, WOS: 000496659300007, Purpose Dysphagia is known to be a disorder of the swallowing function, and is a growing health problem in aging populations. Swallowing screening tests have mostly been studied in comorbidities such as stroke associated with old age. There is no simple, quick and easy screening test to best determine the risk of oropharyngeal dysphagia in geriatric guidelines. We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Methods This cross-sectional and multicenter study was conducted at 13 hospitals between September 2017 and February 2019. the study included 1163 participants aged >= 65 years and who had no secondary dysphagia. Reliability was evaluated for data quality, scaling assumptions, acceptability, reliability, and validity as well as cutoff points, specificity and sensitivity. Results the age distribution of 773 (66.5%) patients was between 65 and 74 years and 347 (29.8%) of them were male and 767 (66%) patients were female. the average total GUSS score was 18.57 +/- 1.41. the Cronbach's alpha was 0.968. There was a moderate statistically significant negative correlation between the total GUSS and 10-item Eating Assessment Tool scores as well as between the total GUSS score and quality of life. the cutoff point of the total GUSS score was 18.50, sensitivity was 95.5% and specificity was 94.4%. Conclusions the GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older people who had no secondary dysphagia. It is suitable as a screen test for clinical practice. Key summary pointsAim We aimed to evaluate whether the Gugging Swallowing Screen (GUSS) test is an effective method for evaluating swallowing difficulty in healthy older people. Findings Total GUSS score sensitivity was 95.5% and its specificity was 94.4%. Message the GUSS test is a valid and reliable test to identify possible oropharyngeal dysphagia risk in healthy older person who had no secondary dysphagia. It is suitable as a screen test for clinical practice.

Akaltun, Mazlum Serdar/0000-0002-9666-9483; Sen, Ekin Ilke/0000-0002-6489-3368; karahan, ali yavuz/0000-0001-8142-913X WOS: 000476771900010 Key summary pointsAimOur aim was to investigate which swallowing difficulty of food consistency in older people who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD) risk.FindingsWe have found that the eating/drinking difficulty of thick liquids was the highest predictive value with respect to OD risk and the eating difficulty of mixed content food had the highest diagnostic ratio.MessageThe present study reports that even in older person who do not go to the hospital with the complaints of swallowing difficulty, the difficulty of swallowing thick liquids and especially the mixed content food should be questioned. AbstractPurposeThe present study aimed to investigate which swallowing difficulty of food consistency in participants over 65years of age who did not have any disease that might affect swallowing functions, and which symptoms were most likely related to oropharyngeal dysphagia (OD).MethodsThe cross-sectional and multicenter study was conducted at 12 hospitals including 883 participants aged >= 65years who were fed orally and who were admitted to the physical medicine and rehabilitation outpatient clinics between September 2017 and December 2018. Demographic characteristics were recorded. Katz Daily Living Activities Index (KDLAI), swallowing-related quality of life scale (Swal-QoL) and 10-item Eating Assessment Tool (EAT-10) were used. The participants were asked the yes or no questions including swallowing difficulty of various types of food consistency with the face-to-face interview.ResultsParticipants were divided into two groups as normal swallowing (EAT-10= 3 group) (n=244) according to the EAT-10 scores. While there was no difference related to number of teeth and KDLAI scores between groups (p=0.327 and p=0.221, respectively), the significant difference was found between groups in terms of yes/no questions and Swal-QoL scores (p

Objective: To assess the relationships between the dissociative features of FMS and the pain, psychological status, and functional status. Methods: Twenty-seven women with fibromyalgia syndrome (FMS) and 24 controls from the Istanbul Physical Medicine and Rehabilitation Hospital (2013-2015) were included in this cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders Structured Clinical Interview for Axis I Disorders was used to evaluate the participants. A visual analogous scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to assess the levels of pain, quality of sleep and functional and psychological statuses. The Dissociative Experiences Scale (DES) was used to evaluate the dissociative features. Results: The BDI, BAI and DES scores were statistically significantly higher in the cases of FMS. There were remarkable associations between all but 2 of the DES and FIQ scores, while positive correlations were found between the DES and, VAS pain and sleep quality scores. The prevalences of current and lifelong dysthymia, and major depressive disorder; not otherwise specified, common anxiety and somatoform disorders were higher in the cases of FMS. Conclusion: Pain, physical function and emotional status appear to be associated with dissociative features in FMS. Further studies are required to define these relationships and improve treatment.

[Purpose] The aim of this study was to assess the effectiveness of a 6-week aerobic exercise program on pain, physical function, and psychological status, and to evaluate the personality characteristics of fibromyalgia syndrome (FMS) patients. [Subjects and Methods] Fourteen women with FMS were enrolled. They were trained for a 6-week home-based aerobic exercise program. The Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, the visual analog scale of pain and sleep quality were measured at baseline and at the end of week 6. The personality profiles were evaluated using the Minnesota Multiphasic Personality Inventory (MMPI). [Results] After the exercise program, significant improvements were determined in pain, sleep quality, physical function, depression and FMS symptoms compared to baseline. In addition, the hysteria item (71.21±8.84) of the MMPI was significantly higher in FMS. [Conclusion] Our findings indicate that home-based aerobic exercise may be a useful treatment in the management of FMS. Personality characteristics should be considered during the planning process of the treatment of FMS. Personality is a filter between life events and psychological responses. It is defined to be the integration of effective and behavioral patterns. Long-term studies involving larger clinical samples are needed to define the role of personality characteristics in FMS.

The aim of this study was to compare the effects of urinary incontinence (UI) and subtypes, including urinary stress incontinence (USI), urinary urge incontinence (UUI), and urinary mixed incontinence (UMI), on sexual function and quality of life (QoL) of women.Sexually active premenopausal consecutive women (n = 153) with UI were enrolled in this study. Sexual function was assessed with the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and QoL was assessed with the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form.The patient population (n = 153) was composed of women with USI (n = 20), UUI (n = 21), UMI (n = 40), and a control group (n = 72) assessed for only routine gynecological evaluation. Infrequency, dissatisfaction, avoidance, and anorgasmia were significantly higher in the UI group compared to the control group (P 0.05). When we compared the USI, UUI, and UMI groups in terms of the subscales of the GRISS, dissatisfaction was significantly higher in the UMI group (P = 0.001). Scores for the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form were significantly higher in the UMI group compared with the UUI group (P0.05).UI has an adverse affect on sexual function and QoL of women. UMI has the greatest impact on sexual function in terms of dissatisfaction compared with USI and UUI. We suggest routine assessment of sexually active women with UI using specific questionnaires to diagnose and treat sexual dysfunction.

Fibromyalgia syndrome (FMS) is associated with widespread musculoskeletal pain disorder characterized by various symptoms. Our aim was to compare the personality profiles and psychological aspects between FMS patients and control subjects. Additionally, we evaluated the FMS symptoms, pain and functional status. A total of 72 female patients with FMS and 64 age- and sex-matched healthy controls were included.Visual Analog Scale (VAS), to assess pain and sleep quality, and Fibromyalgia Impact Questionnaire (FIQ), to evaluate the functional status, were used in both groups. We assessed the psychological status with Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and the personality profiles were evaluated with Minnesota Multiphasic Personality Inventory (MMPI).Total BDI and BAI scores of FMS patients were higher than control subjects (p0.01, p0.01). In terms of psychopathology, hysteria parameters of MMPI were significantly higher in FMS. MMPI parameters except lie, infrequency, masculinity femininity and hypomania parameters (p0.05) were significantly higher in FMS group than the control group.The results of the present study suggest that there is a relationship between the psychological state and personality characteristics in FMS. Much more research is needed to better define the role of personality characteristics in the pathogenesis and symptoms of FMS.

Background and objectives To test the hypothesis that dry needling is more effective than sham dry needling in relieving myofascial pain of the temporomandibular muscles. Material and method Fifty-two subjects with established myofascial trigger points were randomized into two groups; study group (N: 26) and placebo group (N: 26). Dry needling was applied using acupuncture needles. Sham dry needling was applied to the placebo group. Pain pressure threshold was measured with pressure algometry, pain intensity was rated using a 10-cm visual analog scale (VAS) and the unassisted jaw opening without pain measurement was performed. Evaluations were done by a physician blinded to the data. Results Of 52 patients assigned, 50 completed the study. Mean algometric values were significantly higher in the study group when compared to the placebo group (p values being less than 0.05). There were no differences between the two groups in terms of VAS and unassisted jaw-opening without pain values. Conclusion Dry needling appears to be an effective treatment method in relieving the pain and tenderness of myofascial trigger points.

The aim of this study is to assess the effectiveness of the vaginal cone usage in patients with stress urinary incontinence (SUI) treated by hormone replacement therapy (HRT).In this prospective controlled study, vaginal cone therapy is proposed to 22 postmenopausal patients with SUI having HRT who were admitted to Istanbul University, Faculty of Medicine Urogynecology Division. The vaginal cone therapy protocol consisted of one 40-min session per day over a 12-week period at standing position, and to push back the vaginal cone if they feel it slide for 15 times. Control group consisted of ten postmenopausal patients receiving only HRT. For the two groups, perineometry value, pad test, and 3 days average number of incontinence were assessed at the beginning and after 2 months of treatment.In the vaginal cone group, in all parameters a statistically significant difference was observed toward improvement as compared to baseline (p0.01); there were no significant differences (p0.05) in the HRT group. While comparing between the mean differences of two groups, the average number of urinary leakage was decreased and perineometry value was statistically increased (t = 3.74, p0.001; t = 3.24, p0.01) in vaginal cone group rather than in the HRT group which was calculated from the urinary diary.Vaginal cone could be an effective method of treatment in patients with SUI and may be a preferable treatment for patients who have problem to come to hospital and want to work independently at home.

Traumatic brain injury represents a significant public health problem. The importance of this problem derives from high incidence rates, young previously healthy adults comprising a large proportion of those injured and the possibility of persistent functional limitations in survivors. In this article, brain injury epidemiology is summarized, and differences of brain injury between pediatric and elderly persons are emphasized. Traumatic brain injury has been classified by various variables. Underlying physiologic and chemical mechanisms for secondary brain injury regarding strategies and research to minimize this injury are reviewed. Variables that affect outcome after acquired brain injury are described, and the outcome tools most appropriate for the patient populations are discussed. In addition, this article focuses on new neuro-imaging techniques and their potential clinical applications in patients with traumatic brain injury.

High prevalence of metabolic syndrome (MS) and related metabolic disturbances in patients with schizophrenia and bipolar affective disorder have been in main focus of interest in recent years since the introduction of second-generation antipsychotics. This study aims to examine these questions: 1) Is there a relation between antipsychotic treatment and MS prevalence? 2) Which antipsychotic users have higher MS prevalence? 3) Do patients on antipsychotic polytherapy have higher rates of MS than patients on antipsychotic monotherapy? 4) Which metabolic parameters are considerably disturbed on which antipsychotic users?242 Patients with schizophrenia, schizoaffective disorder and bipolar disorder without any other psychiatric comorbidity according to DSM-IV and using the same antipsychotic(s) and/or mood stabilizers at least for the last 6 months included to the final assessment.The sample was divided into 7 drug groups. The MS prevalence was highest in the combined antipsychotic (AA) group (48.1%) according to ATP III criteria. According to IDF criteria clozapine (C) group had the highest MS prevalence (74%).When metabolic parameters evaluated overall, metabolic risk with antipsychotics is found to be highest in clozapine group, followed by combined AP group. Olanzapine and risperidone have intermediate risk while zuclopentixole has lowest.

Objective The aim of this study was to investigate the short-term effects of intra-articular injection of hyaluronan (Hylan G-F 20) on proprioception, isokinetic muscle force, self reported pain, and functional condition in patients with knee osteoarthritis (OA). Methods 63 patients with stage II-III bilateral knee OA were included in this randomized, placebo controlled, and prospective study. Subjects were randomized with 42 of them into the treatment group and 21 of them into the placebo group. Hyaluronan was intraarticularly injected into both knees of the subjects which were in the treatment group, whereas physiological saline was intraarticularly injected to the subjects which were in the placebo group. Proprioception and the isokinetic muscle force measurement were performed. Visual analogue scale (VAS) and WOMAC scale were used to evaluate pain and physical function. Results Statistical analysis was performed on 120 knees of 60 patients completing the trial. The average absolute angular error (AAAE) value showing the proprioceptive error level in the treatment group was detected to be statistically significantly lower compared to placebo at the measurements performed after the 3rd injection (p = 0.02) and after one week (p = 0.01). While there was no inter-group difference in isokinetic measurements performed at 180 and 240 degrees/sec, a significant difference was detected at the measurement performed at 60 degrees/sec in favor of the treatment group (p = 0.02). Activity and resting VAS-pain values, WOMAC parameters (except the WOMAC stiffness) were detected to be significantly lower in the treatment group. Local adverse events were not reported in any patient. Conclusion In this study, it was demonstrated that intraarticular injection of hyaluronan in patients with knee OA led to a short-term increase in proprioception and isokinetic muscle force, and also significant improvements in the functional conditions of patients. Long-term studies are needed.

Background Studies have shown moderate cognitive impairment in patients with Fibromyalgia syndrome (FMS). Mean platelet volume (MPV), a marker of platelet activation. Activated platelets may play role in neuroinflammation and cognitive dysfunction. In addition, recent clinical studies identified the relation between uric acid (UA) and cognitive impairment in neurological diseases. Objectives Our aim was to compare the serum UA and MPV levels between FMS patients and control subjects and to investigate the relationship between UA, MPV and cognitive impairment in patients with FMS. Methods A total of 54 premenopausal female patients with FMS diagnosed according to 1990, 2010 and 2013 ACR criteria referring to Physical Medicine and Rehabilitation outpatient clinic and 33 volunteer healthy control matched according to their ages and genders were enrolled. Visual Analog Scale (VAS), to assess pain and sleep quality, and Fibromyalgia Impact Questionnaire (FIQ), to evaluate the functional status, were used in both groups. We assessed the psychological status with Beck Depression Inventory (BDI) and the frequency of cognitive impairment was evaluated with Mini Mental State Examination (MMSE). Serum MPV, platelet and UA levels were measured. Results were evaluated considering the significance level p Results No statistically significant difference was observed demographic characteristics between FMS and control groups (p>0.05). Mean VAS pain and sleep quality of FMS group were determined significantly higher than control group (p 0.05). No significant correlation was determined between serum UA levels and VAS pain/sleep quality, FIQ, BDI and MMSE scores (p>0.05). Similarly, no significant correlation was found between serum MPV levels and VAS pain/sleep quality, FIQ, BDI and MMSE scores (p>0.05). Conclusions Our results suggest that there were no association between serum UA, MPV and cognitive impairment levels in FMS patients in comparison to control subjects. Many variables, such as age, pain, depression and poor functional status, likely contribute to the cognitive impairment in FMS. References Koc ER, Uzar E, Cirak Y, Parlak Demir Y, Ilhan A. The increase of mean platelet volume in patients with Alzheimer disease. Turk J Med Sci 2014;44(6):1060-6. Vannorsdall TD, Kueider AM, Carlson MC, Schretlen DJ. Higher baseline serum uric acid is associated with poorer cognition but not rates of cognitive decline in women.Exp Gerontol. 2014;60:136-9. Cicero AF, Desideri G, Grossi G, Urso R, Rosticci M, D9Addato S, Borghi C; The Brisighella Heart Study Group. Serum uric acid and impaired cognitive function in a cohort of healthy young elderly: data from the Brisighella Study. Intern Emerg Med 2014 Jul 2. Haliloglu S, Carlioglu A, Sahiner E, Karaaslan Y, Kosar A. Mean platelet volume in patients with fibromyalgia. Z Rheumatol 2014;73(8):742-5. Disclosure of Interest None declared