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We aimed to investigate the relationship among probable sarcopenia, osteoporosis (OP) and supraspinatus tendon (SSP) tears in postmenopausal women. Postmenopausal women screened/followed for OP were recruited. Demographic data, comorbidities, exercise/smoking status, and handgrip strength values were recorded. Probable sarcopenia was diagnosed as handgrip strength values < 20 kg. Achilles and SSP thicknesses were measured using ultrasound. Among 1443 postmenopausal women, 268 (18.6%) subjects had SSP tears. Unilateral tears were on the dominant side in 146 (10.1%) and on the non-dominant side in 55 women (3.8%). In contrast to those without, women with SSP tears had older age, lower level of education, thinner SSP and lower grip strength (all p < 0.05). In addition, they had higher frequencies of hypertension, hyperlipidemia, DM, OP and probable sarcopenia, but lower exercise frequency (all p < 0.05). Binary logistic regression modeling revealed that age [odds ratio (OR): 1.046 (1.024-1.067 95% CI)], hypertension [OR: 1.560 (1.145-2.124 95% CI)], OP [OR: 1.371 (1.022-1.839 95% CI)] and probable sarcopenia [OR: 1.386 (1.031-1.861 95% CI)] were significant predictors for SSP tears (all p < 0.05). This study showed that age, presence of hypertension, probable sarcopenia and OP were related with SSP tears in postmenopausal women. To this end, although OP appeared to be related to SSP tears, SSP tear/thickness evaluation can be recommended for OP patients, especially those who have other risk factors such as older age, higher BMI, hypertension, and probable sarcopenia.
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Hipertensão , Osteoporose , Lesões do Manguito Rotador , Sarcopenia , Humanos , Feminino , Manguito Rotador/patologia , Sarcopenia/complicações , Sarcopenia/epidemiologia , Sarcopenia/patologia , Força da Mão , Pós-Menopausa , Lesões do Manguito Rotador/complicações , Lesões do Manguito Rotador/patologia , Osteoporose/patologia , Hipertensão/patologiaRESUMO
There is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0-10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU.
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Transtornos de Deglutição , Humanos , Técnica Delphi , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/terapia , Turquia , Inquéritos e Questionários , Unidades de Terapia IntensivaRESUMO
The aim of this study was to compare the effects of dry needling (DN) and extracorporeal shock wave therapy (ESWT) in the treatment of plantar fasciitis (PF). The study included 55 patients with PF. The patients were randomly divided into 2 groups. The DN group applied 3 sessions of DN to the myofascial trigger points in the lower limb muscles. The ESWT group applied 3 sessions of ESWT to the plantar fascia. For clinical evaluation, we used a visual analog scale (VAS) (first step, rest, activity) and Foot Function Index (FFI) (pain, disability, activity). Assessments were done baseline, post-treatment first week, and fourth week. Maximum pain-free standing time (Max PfST) and maximum pain-free walking distance (Max PfWD) were recorded at baseline and post-treatment fourth week. In this study, we found significant improvement in VAS, FFI, Max PfST, and Max PfWD in both groups (p < .01). VAS-activity baseline-forth week change was significantly superior in the DN group compared to the ESWT group (p = .023). FFI-disability baseline-fourth week change was significantly superior in the DN group compared to the ESWT group (p = .048). There was no significant difference in other treatment-related changes between the groups (p > .05). However, VAS-rest baseline-fourth week change and FFI-pain baseline-fourth week change trended towards statistical significance between groups ((p = .056), (p = .052) respectively). This study showed that DN may be a good alternative treatment for patients with PF, with effects similar to or even superior to ESWT.
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Agulhamento Seco , Tratamento por Ondas de Choque Extracorpóreas , Fasciíte Plantar , Síndromes da Dor Miofascial , Medição da Dor , Humanos , Fasciíte Plantar/terapia , Feminino , Masculino , Tratamento por Ondas de Choque Extracorpóreas/métodos , Agulhamento Seco/métodos , Pessoa de Meia-Idade , Adulto , Síndromes da Dor Miofascial/terapia , Resultado do Tratamento , Calcanhar/fisiopatologiaRESUMO
COVID-19 is a multisystem disease caused by severe acute respiratory syndrome coronavirus 2. It has been declared a pandemic by the World Health Organization in March 2020 and the outbreak still keeps its impacts worldwide. Behçet disease (BD) is a multi-systemic vasculitis involving the skin, mucosa, eyes, joints, nervous system, cardiovascular system, and gastrointestinal system. The precise etiopathogenesis of the disorder is unknown but autoimmunity is believed to play a key role. A considerable part of patients with BD are susceptible to immunosuppression and are more predisposed to infections than healthy individuals. Hence, the protection and control measures for patients with BD against the COVID-19 are of the utmost significance. Given the requirement to balance proper treatment of BD with the smallest risk of COVID-19 associated mortality and morbidity, we aimed to review the management of BD in the era of the pandemic with a special focus on treatment considerations. According to current expert recommendations, there is no reason to discontinue topical treatments, colchicine, and nonsteroidal antiinflammatory drugs. Systemic steroids can be used at the lowest possible dose if needed. Ongoing treatments can be continued unchanged in patients with no suspected or confirmed COVID-19. In cases with COVID-19 symptoms, immunosuppressive and biological agents can be temporarily stopped but the decision should be made on a case by case basis. Considering their potential beneficial effects on the course of COVID-19, colchicine, pentoxifylline, and dapsone can be considered as safe treatment options in BD.
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Síndrome de Behçet , COVID-19 , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Síndrome de Behçet/epidemiologia , Humanos , Imunossupressores/uso terapêutico , Pandemias , SARS-CoV-2RESUMO
Coronavirus disease (COVID-19) is a highly contagious respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 outbreak has been declared a pandemic by the World Health Organization on March 2020. The pandemic has affected the management of psoriasis not only for those who are under treatment but also for those who are about to begin a new therapy to control their disease. An increasing number of studies in the current literature have focused on the relationship between psoriasis and COVID-19 from different perspectives. This narrative review includes searching the PubMed and Web of Science databases using the keywords "psoriasis," "psoriatic arthritis," "coronavirus," "COVID-19," and "SARS-CoV-2." The search was supplemented by manual searching of reference lists of included articles. A total of 11 relevant original investigations and 6 case studies was identified. The search was updated in May 2019. Due to the absence of randomized controlled trials, it is not likely to have a robust evidence-based approach to psoriasis management in the era of COVID-19. However, the current literature may provide some clues for safety considerations. Conventional immunosuppressive therapies such as methotrexate and cyclosporine, and anti-tumor necrosis factor agents should not be preferred due to increased risk of infection, especially in high-risk areas. The use of cyclosporine may pose additional risk due to the side effect of hypertension, which has been reported to be associated with susceptibility to severe COVID-19. Considering that the current literature has provided no conclusive evidence that biologics increase the risk of COVID-19, withdrawal of these agents should be reserved for patients with COVID-19 symptoms. The treatment approach should be personalized, considering the advantages and disadvantages for each case separately.
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COVID-19 , Imunossupressores/administração & dosagem , Psoríase/tratamento farmacológico , Produtos Biológicos/administração & dosagem , Produtos Biológicos/efeitos adversos , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Humanos , Hipertensão/induzido quimicamente , Hipertensão/complicações , Imunossupressores/efeitos adversos , Fatores de RiscoRESUMO
This study aimed to evaluate the efficiency of extracorporeal shock wave therapy (ESWT) and dry needling (DN) combination on pain and functionality in plantar fasciitis. Forty patients who were clinically diagnosed with plantar fasciitis were included in the study. The patients were randomly divided into 2 groups. The ESWT-DN group was applied 3 sessions of ESWT to plantar fascia and DN to the trigger points in the gastrosoleus muscles. The ESWT group was applied only ESWT treatment to plantar fascia. We used visual analog scale (VAS) for pain and a pressure algometer for pressure pain threshold. The functionality of the patients was evaluated with Foot Function Index (FFI). Also, maximum painless standing time and maximum painless walking distance were recorded. All assessments were repeated twice; first, pretreatment and second 1 month after the treatment. In both groups, there were statistically significant improvements in VAS, pressure pain threshold, maximum painless standing time, maximum painless walking distance, and FFI's pain, disability, and activity limitation subscales scores (p ≤ .001). In intergroup comparison; it was showed that VAS scores, maximum painless standing time (pâ¯=â¯.002), maximum painless walking distance (p ≤ .001), and FFI pain subscale scores (pâ¯=â¯.034) were statistically superior in the ESWT-DN group. There was no statistically difference between the groups in pressure pain threshold (pâ¯=â¯.132), FFI disability (pâ¯=â¯.081), and FFI activity limitation subscale (pâ¯=â¯.226) scores. ESWT and DN combination therapy in plantar fasciitis was seen to be superior in the pain scores. Further studies with larger patients' groups and longer term results of this combination are needed for a better comparison.
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Agulhamento Seco , Tratamento por Ondas de Choque Extracorpóreas , Fasciíte Plantar , Fasciíte Plantar/diagnóstico , Fasciíte Plantar/terapia , Humanos , Dor , Resultado do TratamentoRESUMO
PURPOSE: This study was undertaken to compare the distal femoral cartilage thickness in patients with keratoconus (KC) with that of age- and sex-matched healthy controls, in order to identify a potential risk factor for early osteoarthritis in patients with KC and to allow initiation of early rehabilitation. METHODS: Thirty-six KC patients between 18 and 35 years of age and 36 healthy controls were included in this study. Keratometry readings (K1, K2), central corneal thickness (CCT), anterior chamber depth (ACD), iridocorneal angle (ICA), and corneal volumes (CV) were measured using a Sirius imaging system (Costruzioni Strumenti Oftalmici, Italy). Also, the distal femoral cartilage thickness (DFCT) was assessed bilaterally using ultrasound by the same physiatrist. Lateral femoral condyle (LFC), intercondylar area (ICA), medial femoral condyle (MFC), and body mass index (BMI) values were recorded. RESULTS: Patient and control groups were comparable in terms of age, gender, and BMI. On the other hand, patients with KC had a significant reduction in right LFC, MFC thickness and left ICA, MFC as compared to controls (p < 0.05). In the corneal topographic evaluation of the groups, it was observed that K1, K2, CCT, and ACD values differed significantly. CONCLUSIONS: Detection of thinner DFCT in KC patients suggests that these patients may be future candidates of osteoarthritis.
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Ceratocone , Osteoartrite , Adulto , Topografia da Córnea , Humanos , Itália , Ceratocone/diagnóstico , Ceratocone/epidemiologia , Ceratocone/etiologia , Fatores de RiscoRESUMO
Stroke is damage to the central nervous system due to vascular pathology. Stroke causes many complications. One of the most important of these complications is dysphagia. Dysphagia is a major cause of morbidity and mortality. In recent years, the benefits of using interferential current (IFC) stimulation in the treatment of dysphagia due to various etiologies have been demonstrated. However, there are significant gaps in the literature regarding patient populations, treatment procedures, and evaluation of treatment response. Here, we report the treatment of three cases of dysphagia after ischemic stroke with IFC stimulation and review the current literature. The patients had no previous treatment for dysphagia and were using only compensatory methods. This case report highlights the benefit of IFC stimulation in the treatment of post-stroke dysphagia both clinically and videofluoroscopically. It should be kept in mind that IFC stimulation may be an important alternative in the treatment of post-stroke dysphagia.
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OBJECTIVE: This study aimed to assess the quality, readability, and comprehension of texts generated by ChatGPT in response to commonly asked questions about spinal cord injury (SCI). METHODS: The study utilized Google Trends to identify the most frequently searched keywords related to SCI. The identified keywords were sequentially inputted into ChatGPT, and the resulting responses were assessed for quality using the Ensuring Quality Information for Patients (EQIP) tool. The readability of the texts was analyzed using the Flesch-Kincaid grade level and the Flesch-Kincaid reading ease parameters. RESULTS: The mean EQIP score of the texts was determined to be 43.02 ± 6.37, the Flesch-Kincaid reading ease score to be 26.24 ± 13.81, and the Flesch-Kincaid grade level was determined to be 14.84 ± 1.79. The analysis revealed significant concerns regarding the quality of texts generated by ChatGPT, indicating serious problems with readability and comprehension. The mean EQIP score was low, suggesting a need for improvement in the accuracy and reliability of the information provided. The Flesch-Kincaid grade level indicated a high linguistic complexity, requiring a level of education equivalent to approximately 14 to 15 years of formal education for comprehension. CONCLUSIONS: The results of this study show heightened complexity in ChatGPT-generated SCI texts, surpassing optimal health communication readability. ChatGPT currently cannot substitute comprehensive medical consultations. Enhancing text quality could be attainable through dependence on credible sources, the establishment of a scientific board, and collaboration with expert teams. Addressing these concerns could improve text accessibility, empowering patients and facilitating informed decision-making in SCI.
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Compreensão , Letramento em Saúde , Humanos , Reprodutibilidade dos Testes , Escolaridade , Leitura , InternetRESUMO
Baxter's neuropathy is one of the overlooked causes of chronic heel pain. Diagnosing neuropathy in Baxter's can be challenging due to its potential occurrence as a secondary condition to other common syndromes that cause heel pain, such as plantar fasciitis, calcaneal spur, hypertrophic muscle, tenosynovitis, space-occupying lesions or trauma. Ultrasound is a reliable and easily accessible device that guides injections for the treatment of Baxter's neuropathy. We have written this letter as a guide, especially for beginner and professional pain specialists.
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OBJECTIVE: The aim of this study is to analyze the quality, reliability, comprehensibility, and the mentioned medical concepts of traumatic brain injury (TBI) related videos on YouTube. METHODS: "Traumatic brain injury (TBI)" and Google Trends related queries were used, and 328 videos were included. Categorization, quality assessment via a 5-point Global Quality Scale, reliability evaluation using a modified DISCERN scale, comprehensibility assessment using Flesch-Kincaid Reading Ease and Flesch-Kincaid Grade Level, and consensus-based classification for usefulness were performed. Target audience categorization was content-based. Text mining techniques were used to identify biomedical terms in video transcripts. RESULTS: Most of the videos were intended for nonhealthcare professionals and deemed useful. The videos had intermediate quality and a moderate level of reliability. The comprehensibility of the videos exceeded the recommended levels. Videos predominantly covered TBI symptoms, the severity of the condition, its impact on individuals, and possibly strategies related to diagnosis and treatment. CONCLUSIONS: Results suggest the requirement for higher quality and reliability in YouTube content about TBI. Emphasis should be placed on clear and accurate language to promote comprehensibility. Continued research, guidelines, education, and platform oversight can enhance the spread of reliable health information on social media, benefiting creators, and consumers in this field.
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Lesões Encefálicas Traumáticas , Compreensão , Mídias Sociais , Gravação em Vídeo , Humanos , Lesões Encefálicas Traumáticas/diagnóstico , Reprodutibilidade dos Testes , PercepçãoRESUMO
Accessible, accurate information, and readability play crucial role in empowering individuals managing osteoporosis. This study showed that the responses generated by ChatGPT regarding osteoporosis had serious problems with quality and were at a level of complexity that that necessitates an educational background of approximately 17 years. PURPOSE: The use of artificial intelligence (AI) applications as a source of information in the field of health is increasing. Readable and accurate information plays a critical role in empowering patients to make decisions about their disease. The aim was to examine the quality and readability of responses provided by ChatGPT, an AI chatbot, to commonly asked questions regarding osteoporosis, representing a major public health problem. METHODS: "Osteoporosis," "female osteoporosis," and "male osteoporosis" were identified by using Google trends for the 25 most frequently searched keywords on Google. A selected set of 38 keywords was sequentially inputted into the chat interface of the ChatGPT. The responses were evaluated with tools of the Ensuring Quality Information for Patients (EQIP), the Flesch-Kincaid Grade Level (FKGL), and the Flesch-Kincaid Reading Ease (FKRE). RESULTS: The EQIP score of the texts ranged from a minimum of 36.36 to a maximum of 61.76 with a mean value of 48.71 as having "serious problems with quality." The FKRE scores spanned from 13.71 to 56.06 with a mean value of 28.71 and the FKGL varied between 8.48 and 17.63, with a mean value of 13.25. There were no statistically significant correlations between the EQIP score and the FKGL or FKRE scores. CONCLUSIONS: Although ChatGPT is easily accessible for patients to obtain information about osteoporosis, its current quality and readability fall short of meeting comprehensive healthcare standards.
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Inteligência Artificial , Osteoporose , Humanos , Feminino , Masculino , Compreensão , Saúde PúblicaRESUMO
Myofascial trigger points are among the often-overlooked causes of anterior abdominal wall pain and primer dysmenorrhea. It is crucial to evaluate patients with a myofascial perspective in addition to a good history and a detailed physical examination. Myofascial trigger points of the abdominal oblique muscles and rectus abdominis muscle should be considered for patients with abdominal wall pain and primer dysmenorrhea. It should also be kept in mind that myofascial pain syndrome may be the primary pathology responsible for the pain, or it may be an entity accompanying another underlying pathology.
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Parede Abdominal , Fibromialgia , Síndromes da Dor Miofascial , Feminino , Humanos , Pontos-Gatilho , Dismenorreia/diagnóstico , Dismenorreia/terapia , Dismenorreia/complicações , Síndromes da Dor Miofascial/diagnóstico , Síndromes da Dor Miofascial/terapia , Síndromes da Dor Miofascial/complicaçõesRESUMO
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Agulhamento Seco , Doenças Musculares , Humanos , Ultrassonografia , Ultrassonografia de IntervençãoRESUMO
AIM: This study aims to evaluate the educational quality of videos related to ultrasound guided dry needling (USDN). Material and method: This study was designed as a cross-sectional study. A video-based search was performed on the YouTube online video sharing platform (https://www.youtube.com/) using the English keywords "ultrasound guided dry needling" on May 10, 2023. The first 60 videos were analysed. RESULT: The first 60 videos were analyzed, and 32 videos that met the inclusion criteria were included in the study. The content of the videos mostly consisted of technical knowledge regarding Ultrasound Guided Dry Needling (USGDN) (56.3%) and information (43.84%). The total mean DISCERN score was 26.9 ± 12.0 (range 17 to 54). The total mean JAMA Score was 2.4 ± 0.7 (range 2 to 4). There was no significant differences between the groups, according to the DISCERN, and JAMAs scores (all p>0.05). The video with the highest DISCERN score belongedto The American Institute of Ultrasound in Medicine (AIUM) channel. CONCLUSION: There is a significant amount of content available on YouTube regarding USDN; however, unfortunately, most of the existing content is of low quality and carries the risk of misinformation. Healthcare professionals should be aware of the importance of health-related information on YouTubeand strive to provide high-quality, accurate, and up-to-date content.
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Agulhamento Seco , Mídias Sociais , Humanos , Estudos Transversais , Indução Percutânea de Colágeno , Ultrassonografia , Reprodutibilidade dos Testes , Gravação em VídeoRESUMO
Objectives: The aim of this study was to compare the efficacy of the corticosteroid (CS) injection and shock wave therapy (SWT) in the treatment of greater trochanteric pain syndrome (GTPS). Patients and methods: Between 2020 September and 2021 October, a total of 60 patients with GTPS (12 males, 48 females; mean age: 50.8±8.5 years; range, 34 to 65 years) were included. The patients were randomly assigned to two groups as the SWT group (n=32) receiving one session of SWT per week for a total of three weeks and CS injection group (n=28) receiving CS and local anesthetic. Both groups were evaluated using the Short Form-36 (SF-36) at baseline and three months and using the Visual Analog Scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at baseline, three weeks, and three months. Results: The mean VAS, greater trochanter tenderness, and WOMAC scores of both groups were similar at baseline, while the third-week and three-month scores were significantly lower in both groups compared to baseline (p<0.05). There was no significant difference in the treatment efficacy between the groups (p>0.05). There was a similar improvement in SF-36 physical function, physical role difficulty, and pain subscales in both groups (p<0.05). Conclusion: Our study results show that both CS injection and SWT are effective modalities and none of the treatments is superior to each other.
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The etiology of plantar heel pain is multifactorial. Myofascial trigger points of abductor hallucis muscle one of the muscles that should be carefully evaluated and treated in patients diagnosed with plantar fasciitis.
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Fasciíte Plantar , Pontos-Gatilho , Humanos , Fasciíte Plantar/diagnóstico , Fasciíte Plantar/terapia , Músculo Esquelético , Pé , DorRESUMO
AIM: In this study, our primary aim was to compare ultrasound (US) findings of the median nerve between rheumatoid arthritis (RA) with carpal tunnel syndrome (CTS) (RA(+)CTS), RA without CTS (RA(-)CTS) and healthy controls (HC) and to determine the optimal US parameters to detect the presence of CTS in RA patients. METHODS: 65 RA patients and 25 HC patients were included in this study. The diagnosis of CTS was made according to the clinical history and physical examination of the participants. Median nerve cross-sectional area(CSA) was measured at the carpal tunnel inlet(CTI), outlet(CTO), and forearm level by the US. In addition, anteroposterior(AP) and mediolateral(ML) diameters of the median nerve were measured. After the measurements, wrist-to-forearm ratio, wrist-to-forearm difference, and flattening ratio were calculated. The presence of tenosynovitis was investigated. RESULTS: CTS was detected in 26(40.0%) of 65 RA patients who participated in the study. CTS was detected in 43(35.2%) of 122 wrists of 65 RA patients. CTI CSA, CTO CSA, forearm CSA, anteroposterior/mediolateral diameter, wrist-to-forearm ratio, wrist-to-forearm difference, and flattening ratio were significantly higher in RA(+)CTS than in RA(-)CTS and HC(p<0.01). In addition, CDAI and CTI CSA(r=0.322, p<0.01), CTO CSA(r=0.301, p<0.01), CTI-to-forearm ratio(r=0.345, p<0.001), CTI-to-forearm difference(r=0.362, p<0.01) and CTO-Forearm difference(r=0.304, p<0.01) moderate correlation was found between. The frequency of tenosynovitis was higher in wrists with CTS than in wrists without CTS (p<0.05). CONCLUSION: While the presence of CTS in RA patients is sonographically evaluated, it may be useful to evaluate parameters such as CTI-to-forearm difference, ratio, and CTI ML diameter rather than just sticking to CTI CSA during diagnosis. Correlations of these parameters with disease activity can also be noted.