Lumbar erector spinae plane block versus infrainguinal fascia iliaca compartment block for pain management after total hip arthroplasty: a randomized clinical trial.

OBJECTIVE: We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain after total hip arthroplasty surgery. METHODS: A total of 60 patients were randomized into 2 groups (n = 30): one that received FIC blocks and one that received ESP blocks. FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded. RESULTS: The dynamic pain scores on movement in the postoperative first hour were significantly lower in the ESP block group than in the FIC block group (3 [2-4] vs 4 [2-5], respectively; P = .035). Data are expressed as median (25th-75th percentiles). Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than in the ESP block group (80 mg [61-100] vs 100 mg [80-120], respectively; P = .010). The adverse effects of opioids did not differ between the 2 groups. CONCLUSION: ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period. TRIAL REGISTRATION: www.ClinicalTrials.gov (ID: NCT05621161).

Results of arthroscopic treatment for anteroinferior shoulder instability using a single anterior working portal using birdbeak.

BACKGROUND: The shoulder joint is the joint with the most dislocations in all joints. The arthroscopic surgery method is considered the gold standard because it creates less soft tissue damage, shorter hospitalization and surgery time, and less restriction of movement after surgery in shoulder instability. Anterior single portal technique has become popular recently. In this study, it was aimed to evaluate the results of the anterior single portal repair technique using "birdbeak". We try to evaluate if this technique is a reliable technique and has the same or more advantages of two portal arthroscopic surgery and make the surgery easier for surgeons. METHODS: In the total of 40 patients who underwent arthroscopic surgery for traumatic recurrent anterior shoulder dislocation between January 2017 and February 2020, this study included 19 patients with the surgical technique of arthroscopic isolated anterior labrum tear repair using a birdbeak from the anterior single working portal. Clinical results were evaluated with the Simple Shoulder Test (SST), Rowe Score for Instability (RWS) and Oxford Shoulder Instability Score (OSIS) tests before and after surgery. The relationship between the time to surgery after the first dislocation and clinical outcomes was also examined in the study. Kolmogorov-Smirnov and Shapiro-Wilk tests were used to control the assumption of normality. In addition, Pearson correlation and Spearman correlation analyzes were used to test the relationship between the variables. RESULTS: The mean follow-up period of the 19 patients included in this study was 33.1 months. The mean time to surgery after the first dislocation was 18.4 months. The mean preoperative number of dislocations was 5.3. The mean number of anchors used in the repair was 2.1. No recurrent dislocations were observed after surgery. A significant difference was observed between preoperative and postoperative SST, RWS and OSIS scores (respectively, p = 0.000 < 0.001, p = 0.000 < 0.001, p = 0.000 < 0.001). There was no statistically significant relationship between the time elapsed after the first dislocation and the postoperative SST, RWS, OSIS scores (respectively, p = 0.43 > 0.05, p = 0.39 > 0.05, p = 0.31 > 0.05). CONCLUSION: It has been observed that the repair technique applied using the "birdbeak" from the anterior single working portal is a successful treatment, and further studies are required due to the limited literature.

Validity and reliability of the Turkish version of the adult ADHD Self-Report Screening Scale for DSM-5.

BACKGROUND: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. AIMS: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. STUDY DESIGN: Methodological and cross-sectional study. METHODS: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. RESULTS: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cut-off score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. CONCLUSION: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.

Oxidative stress markers, cognitive functions, and psychosocial functioning in bipolar disorder: an empirical cross-sectional study

Objective: This study aimed to evaluate the relationship between oxidative stress markers and cognitive functions and domains of psychosocial functioning in bipolar disorder. Methods: Oxidative stress markers, cognitive functions, and domains of psychosocial functioning were evaluated in 51 patients with bipolar disorder who were in remission. Correlation analyses between these parameters were calculated with data controlled for duration of illness and number of episodes. Results: There was no statistically significant correlation between oxidative stress markers and cognitive functions. In terms of psychosocial functioning, significant correlations were found between malondialdehyde and sense of stigmatization (r = -0.502); household activities and superoxide dismutase (r = 0.501); participation in social activities and nitric oxide (r = 0.414); hobbies and leisure time activities and total glutathione (r = -0.567), superoxide dismutase (r = 0.667), and neurotrophin 4 (r = 0.450); and taking initiative and self-sufficiency and superoxide dismutase (r = 0.597). There was no correlation between other domains of psychosocial functioning and oxidative stress markers. Conclusion: These results imply that oxidative stress markers do not appear to correlate clearly with cognitive impairment and reduced psychosocial functioning. However, there were some associations between selected oxidative markers and activity-oriented functional markers. This may represent a true negative association, or may be an artifact of oxidative stress being a state rather than a trait marker. .

Oxidative stress in schizophrenia: a case-control study on the effects on social cognition and neurocognition.

BACKGROUND: Schizophrenia is a debilitating mental disorder that presents impairments in neurocognition and social cognition. Several studies have suggested that the etiology of schizophrenia can be partly explained by oxidative stress. However, our knowledge about the implications of oxidative stress on illness-related cognitive deficits is still far from being clear. The aim of this work was to study the role of oxidative stress molecules on social cognition and neurocognition in patients with schizophrenia. METHODS: We assessed the peripheral levels of several molecules associated with oxidative stress, namely nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), homocysteine, superoxide dismutase (SOD) and neurotrophin 4/5 (NT4/5), in forty-one patients with schizophrenia and forty-three healthy participants. A battery of tests to measure neurocognition and social cognition was also administered to the schizophrenia group. RESULTS: We found that the schizophrenia group presented substantially higher levels of oxidative stress than the control group, as revealed by elevated quantities of the pro-oxidants NO and MDA, and decreased levels of the antioxidants GSH, SOD and NT4/5. Interestingly, the levels of NT4/5, which have been shown to have antioxidant effects, correlated with executive functioning, as measured by two distinct tests (WCST and TMT). However, social cognition and symptom severity were not found to be associated with oxidative stress. CONCLUSIONS: We propose a protective role of NT4/5 against oxidative stress, which appears to have a potentially beneficial impact on neurocognition in schizophrenia.

Development of a quality of life scale specific for patients with benign prostatic hyperplasia.

PURPOSE: The improvement of quality of life (QoL) should be the major concern in any proposed treatment modality for any disorder. The objective of this study was to develop a new easy to use benign prostatic hyperplasia (BPH)-specific QoL scale that may guide the treatment policy in BPH. METHODS: A total of 118 items addressing BPH-specific QoL were produced. After an elimination process, a 20-question scale was developed. This new scale, Short Form (SF)-36 and International Prostate Symptom Score (IPSS), was then administered to 50 healthy men (control group), and 108 BPH patients who received medical or surgical treatment. Reliability assessment consisted of internal consistency evaluation by the Cronbach's alpha reliability test. In construct validity, factor analysis was performed using principal component analysis with Varimax rotation. Response to change of this new form was also evaluated. RESULTS: Cronbach's alpha coefficient of this scale was found to be 0.8464. Item-total correlation coefficients were between 0.3298 and 0.7886 (p < 0.0001). Factor analysis for construct validity revealed four factors. The correlation coefficients were found to be r = 0.801 (p < 0.0001) with the total IPSS, and this new QoL scale had a relatively sufficient correlation with all domains of the SF-36. Moreover, a QoL score obtained by the summation of individual grades of each item may provide valuable information just like total IPSS. The mean QoL score was 4.96 ± 9.58 and 20.28 ± 9.14 in controls and BPH patients, respectively (p < 0.0001). Moreover, QoL score significantly improved by both medical and surgical treatment. CONCLUSIONS: The new BPH-specific QoL was shown to be reliable and valid.

The impact of co-morbid conditions on the SF-36: a primary-care-based study among hypertensives.

BACKGROUND: Comorbidities in hypertension complicate the course causing more symptoms and deterioration in a patient's daily life. The aim of this present study is to describe the effect of comorbid conditions on health-related quality of life (HRQL) in hypertensive patients. METHODS: The study was carried out in four different regions of Turkey by 156 general practitioners between October 1999 and April 2000. In addition to cardiological evaluation, SF-36 health survey questionnaire was used for quality of life measurement. Diagnosis of comorbid conditions were anamnesis based. RESULTS: The mean age of the group (n=938) was 58.1 +/- 11.2, and 58.6% (n=550) of the group was female. Total scores of the eight domains of SF-36 were lower than the normal population scores. Age and gender affected every domain of SF-36 scale negatively. Heart failure affected four of the domains, primarily physical domains. Previous transient ischemic attack was responsible for low HRQL in emotional role difficulties, vitality, and mental health, but previous stroke had an impact on physical functioning and emotional role. Previous myocardial infarction affected emotional role difficulties negatively whereas previous CABG surgery had a positive impact on the same domain. Obesity and angina pectoris affected physical functioning negatively, whereas peripheral arterial disease caused low general health perception. Nephropathy, retinopathy and diabetes had no impact on HRQL in hypertension. CONCLUSIONS: When the contribution of comorbid conditions is taken into consideration, it can be noticed that the impact of every other condition is similar to the same condition when it is pure. Hypertension per se seems to cause less impairment than expected in HRQL.