Outcomes of Lumbosacral Fixation in Patients with Suicidal Jumper's Fractures: A Retrospective Study from a Single Center in Turkey.

BACKGROUND Suicide attempts that involve jumping from a great height may not be fatal but can result in lumbosacral facture-dislocations. This retrospective study aimed to present the experience from a single center in Turkey of 21 patients with lumbosacral facture-dislocations, or suicidal jumper fractures, treated with lumbosacral fixation between 2015 and 2022. MATERIAL AND METHODS The study included 21 patients. The diagnosis was established through X-ray and computed tomography (CT) examinations. Neurological damage was assessed using the Gibbons score. Among the patients, 2 were classified as Roy-Camille type 1, 12 as Roy-Camille type 2, and 7 as Roy-Camille type 3. Morphologically, 8 patients had H-type fractures, 7 had T-type fractures, and 6 had U-type fractures. Bilateral spinopelvic fixation was performed. Functional outcomes were evaluated using the Majeed score. RESULTS The average Injury Severity Score (ISS) was 31.6±12.2. The mean duration of surgery was 123.6±44.9 minutes. According to the Majeed score, excellent results were observed in 8 individuals (40%), good results in 5 individuals (25%), fair results in 5 individuals (25%), and poor results in 2 individuals (10%). Out of 18 patients with neurological deficits, 14 showed improvement after surgery, while 4 continued to experience deficits. CONCLUSIONS The findings from this study highlight the importance of obtaining a clear history of the cause of lumbosacral facture-dislocation, as attempted suicide by jumping from a height can cause specific types of injury to the lumbar spine and sacrum that require rapid diagnosis and management to reduce the incidence of permanent paraplegia.

The Effects of Corrosion and Fire Damage on the Steel-Bolted T-Section Connections Used in the Steel Construction.

The most common type of connection in steel structures is the T-section connection. Steel structures can be damaged due to environmental effects such as earthquakes, fires, corrosion, etc., in real applications used in industry. Therefore, in this study, the corrosion and fire condition effects that occur in the T-section connection on the behavior of the connection zone were investigated. The study was carried out with 18 T-section connections with various corrosion (hydrochloric acid and sulfuric acid) in different layers at 5, 10, 15, and 20% corrosion levels, and fire (ISO834) conditions after corrosion have been evaluated and compared. T-section-bolted joints examined in the study were produced using IPE300 standard profiles. In the first part of the study, the behavior of the 18 T-section connections under an axial tensile load has been determined experimentally. The second part created a finite element model with the ABAQUS program for all models. It was seen that the finite element model analysis results converged with the results obtained as a result of the experimental study. As a result, compared to H2SO4 corrosion, HCl corrosion has little effect on the load-deformation characteristics of the connections. Also, if corrosion specimens are exposed to fire, then the connections will change from semirigid to hinged.

Negative effects of the COVID-19 pandemic on the musculoskeletal system and depression in healthcare professionals.

BACKGROUND: During the COVID-19 pandemic, it is thought that healthcare workers are most exposed to musculoskeletal disorders. However, there are limited studies in the literature examining the musculoskeletal disorders among healthcare workers during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to examine musculoskeletal problems and psychological disorders in healthcare personnel working at Dicle University Faculty of Medicine and Research Hospitals during the COVID-19 pandemic and to come up with solutions for rehabilitation. METHODS: The Cornell Musculoskeletal Disorder Questionnaire (CMDQ) was used to assess musculoskeletal problems in the past week. Additionally, Beck depression inventory (BDI) was used to evaluate the psychological state of the participants. Questions on demographic characteristics, habits, the presence and localisation of musculoskeletal system (MSS) diseases, severity and duration of pain, chronic diseases, trauma history and working conditions were included in the questionnaire prepared by the researchers. RESULTS: The study included 74 nurses, 42 residents, 26 specialists, 24 technicians, 16 dentists, 12 physiotherapists, and 26 other allied health personnel. Dentists had the highest total CMDQ score (160.73) whereas resident doctors had the lowest total CMDQ score (98.33). Low back, neck and back pain were the most common MSS problems. BDI was highest in nurses and 70.27% of the nurses were women. The total workplace ergonomics score was found to be 25.91%, and the visual analogue scale (VAS) was highest in nurses (6.72). CONCLUSIONS: While MSS pain is concentrated on the waist, neck and back regions in all healthcare workers. We concluded that the uncertainty associated with the pandemic, delay in preventive measures such as vaccination and medication, rapid and strong transmission of the disease and increasing number of deaths have led to an increase in stress, depression and burnout among healthcare workers.

Piezoelectric Materials in Civil Engineering Applications: A Review.

This review presents the important applications of piezoelectric materials in civil engineering in recent years. Studies on the development of smart construction structures have been carried out by using materials such as piezoelectric materials around the world. Piezoelectric materials have attracted attention in many civil engineering applications, as a result of their capability of generating electrical power when subjected to a mechanical stress, or of generating mechanical stress when subjected to an electric field. In civil engineering applications, piezoelectric materials are used in energy harvesting not only in superstructures but also in substructures, control strategies, the creation of composite materials with cement mortar, and structural health monitoring systems. With this perspective, the civil engineering applications of the piezoelectric materials were reviewed and discussed, especially for their general properties and effectiveness. At the end, suggestions were made for future studies using piezoelectric materials.

Examination of Musculoskeletal System Disorders and Ergonomic Conditions in the Work Environment of Academics Providing Distance Education During the COVID-19 Pandemic: Controlled Study.

BACKGROUND This study aimed to evaluate whether the incidence rate of musculoskeletal system disorders changed owing to the increase in the time spent on the computer by academics who did or did not provide distance education during the COVID-19 pandemic. MATERIAL AND METHODS The Cornell Musculoskeletal Discomfort Questionnaire was used to assess musculoskeletal discomfort experienced in the past 1 week. In addition, the Occupational Safety and Health Administration (OSHA) Computer Workstations Evaluation Checklist was used to assess the ergonomic structure of the work environment. The questionnaire assessed musculoskeletal system disorders and collected demographic characteristics. RESULTS The study group included 184 (101 male, 83 female) academics who provided distance education, whereas the control group included 82 (44 male, 38 female) academics who did not provide distance education. The mean ages of academics in the study group and control group were 37.46±7.34 and 41.26±10.06 years, respectively. Although computer-based work environment ergonomics were similar (P>0.05) in both groups during the pandemic, the incidence rate of musculoskeletal disorders was significantly high in the study group (P<0.001). These disorders were mostly seen in the neck, back, and waist regions (P<0.001). CONCLUSIONS The results suggested that the incidence rate of musculoskeletal disorders increased in academics who provided distance education during the COVID-19 pandemic.

Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians.

Background: In Turkey, childhood vaccination rates are decreasing in the context of increasingly visible antivaccination movements. Aims: To evaluate the antivaccination movement based on communication experiences between family physicians and antivaccine parents in Turkey. Methods: We conducted 39 face-to-face in-depth interviews with family physicians in Sakarya Province who had experiences of communicating with antivaccine parents during October-December 2019. With the permission of the participants, audio recording was obtained in all interviews except one; these were transcribed verbatim and checked. A thematic approach was used to analyse the data. Results: The most common concern about vaccination was the possible side-effects, followed by the origin of the vaccines, religious concerns and distrust of vaccines. The physicians said they assumed an inquisitive, informative and anxiety-relieving attitude towards antivaccine parents.They said they were able to persuade most parents to vaccinate their children and that highly educated parents or those whose attitudes and behaviours were strongly influenced by their religious leaders were the hardest to convince. Physicians emphasized the importance of trust in increasing vaccine acceptance and noted the need to educate religious leaders and families to introduce mandatory vaccination policies. Conclusion: Parents had various reasons for refusing childhood vaccinations, however, the family physicians used persuasive methods to convince them to accept the vaccinations. Strengthening the communication and persuasive skills of health care professionals regarding vaccination may help increase acceptance of childhood vaccinations.

Novel coronavirus seropositivity and related factors among healthcare workers at a university hospital during the prevaccination period: a cross-sectional study.

BACKGROUND: This study aimed to investigate the specific risk factors for the transmission of novel coronavirus (SARS-CoV-2) among healthcare workers in different campuses of a university hospital and to reveal the risk factors for antibody positivity. METHODS: In this retrospective cross-sectional study, 2988 (82%) of 3620 healthcare workers in a university hospital participated. The coronavirus disease 2019 (COVID-19) antibody was investigated using serum from healthcare workers who underwent COVID-19 antibody testing. The antibody test results of the participants were evaluated based on their work campus, their profession and their workplace. The statistical significance level was p < 0.05 in all analyses. RESULTS: Of the participants in this study, 108 (3.6%) were antibody positive, and 2880 (96.4%) were negative. Antibody positivity rates were greater in nurses compared with other healthcare workers (p < 0.001). Regarding workplace, antibody positivity was greater in those working in intensive care compared to those working in other locations (p < 0.001). CONCLUSIONS: Healthcare workers are at the highest risk of being infected with COVID-19. Those who have a higher risk of infection among healthcare workers and those working in high-risk areas should be vaccinated early and use personal protective equipment during the pandemic. TRIAL REGISTRATION: Retrospective permission was obtained from both the local ethics committee and the Turkish Ministry of Health for this study (IRB No:71522473/050.01.04/370, Date: 05.20.2020).

The effect of video presentation showed in the outpatient clinic waiting area on the success of inhaler device use in chronic respiratory diseases.

BACKGROUND/AIM: Nonadherence to inhalation therapy and incorrect inhalation technique is an important problem for optimal disease management in patients with chronic respiratory disease. The aim of the study is to investigate the effectiveness of an inexpensive and effortless method which would be able to improve the inhalation technique of patients. MATERIALS AND METHODS: The video showing the correct use of inhaler devices was played continuously for 3 months in the waiting room of the chest diseases polyclinic, on the big screen TV. The patients, who were not prompted to watch the video, were divided into two groups, as those who visited the outpatient clinic before (n = 300, Group 1) and after (n = 300, Group 2) the video playback began. Patients' ability to use their own inhaler devices was observed without intervention, scored according to the standard 'Ability of Inhaler Device Use' scale and the two groups were compared. RESULTS: The inhaler use skill of the patients in the second group was significantly higher except for the Turbuhaler. In Group 2, among the "video watchers" subgroup, there was significant improvement in all device types. CONCLUSION: Presentation of the use of inhaler devices on the screens in the waiting area of the outpatient clinics of health facilities will provide significant benefits and allow reducing the failure of treatment due to incorrect/incomplete device usage.

Development, validity and reliability study of a compliance scale for the COVID-19 outbreak prevention recommendations

Background/aim: During the intense periods of the COVID-19 pandemic, legal measures were taken for its containment. However, since legal precautions cannot be implemented continuously, hand washing, mask usage and obeying social distance rules are important in combating the pandemic. Complying with these rules is mostly individual decisions. The behavior of individuals has a prominent place in the course of the pandemic. In this study, we aimed to develop a scale which could measure compliance with outbreak measures. Materials and methods: This study was conducted in two stages after evaluation of the content validity of the item pool formed by the research group by experts. For construct validity, the scale subdimensions were determined in 250 people between the ages of 18-70 years at the first stage and the definitive version of the 20-item scale was constructed. In the second stage, exploratory factor analysis was repeated in a group of 484 people, and confirmatory factor analysis was performed. Cronbach's alpha coefficients, Spearman-Brown coefficients, test-retest methods were used to determine reliability. Results: The variance explanation of the scale consisting of 20 items and two subdimensions in the explanatory factor analysis is 63.434% (n = 484). Confirmatory factor analysis resulted in CMIN/DF = 3.540, RMR = 0.043, NFI Delta 1 = 0.928, TLI rho 2 = 0.939, CFI = 0.947, RMSEA = 0.072, SRMR = 0.0368. Cronbach's alpha value of the scale is 0.95; and the Spearman Brown coefficient equal length analysis resulted in 0.928. The temporal consistency of the scale was evaluated with the test-retest method (P = 0.893). The structure, content validity, temporal consistency, item discrimination, and internal consistency were evaluated and found to have acceptable valid, reliable properties. Conclusion: The outbreak prevention recommendation compliance scale is a valid and reliable tool with which compliance with the prevention plans can be evaluated.

Factors affecting the anxiety levels of adolescents in home-quarantine during COVID-19 pandemic in Turkey.

BACKGROUND: The long-term closing of schools and home-quarantine during the COVID-19 pandemic cause negative effects on the physical and mental health of young people. Studies evaluating the mental health of adolescents during the pandemic are limited in the literature. AIM: In our study, it was aimed to determine the results of home-quarantine measures taken for adolescents during the pandemic and the affecting factors. METHOD: This study was conducted as an online cross-sectional self-report questionnaire and included children aged between 12 and 18 years. The data were obtained from the children of volunteer families via Facebook family groups, and Google Forms questionnaires sent by the child psychiatry clinic to their smartphones. Sociodemographic form, State-Trait anxiety scale, and UCLA loneliness survey were used as data collection tools. RESULTS: We examined the data of 745 adolescents. The average age of the study group was 16.83 ± 1.66 years, and 69.5% were females. It was determined that 88.2% of the adolescents followed the developments in the COVID-19 process and obtained most information from the television. State anxiety was related to "Former psychiatric referral" by 4.39-fold, "Having a COVID positive patient in the family or your surroundings" by 3.81-fold, and "The most common medium for obtaining COVID-related information" by 2.41-fold. CONCLUSIONS: Closure of schools and home-quarantine during pandemic causes anxiety and loneliness in young people. The identification of risky groups helps to properly support these individuals by various social connections, including healthcare professionals, families, and schools.

The effects of favipiravir on hematological parameters of covid-19 patients.

INTRODUCTION: This study aims to evaluate changes in hematological parameters after the follow-up of patients who received treatment with favipiravir due to COVID-19 infections. METHODS: Sixty-two cases receiving favipiravir treatment for at least five days due to COVID-19 infection were evaluated retrospectively. Parameters including age, gender, nasopharyngeal swab positivity, and chronic diseases were analyzed. Hematologic parameters were analyzed before and after the treatment. RESULTS: The mean age of the patients receiving treatment with favipiravir was 63.7±12.3 years. Nasopharyngeal swab positivity was detected in 67.7%. The most common comorbid conditions detected in patients were hypertension in 25 cases (40.3%) and diabetes in 16 cases (25.8%). In the statistical analysis of the hematological parameters before and after treatment with favipiravir, WBC, PT-PTT-INR levels were found to be unaffected; the mean RBC was found to have decreased from 4.33 ± 0.58 M/uL to 4.16 ± 0.54 M/uL (p:0.003); the median hemoglobin level was found to have decreased from 12.3 g/dl to 11.9 g/dl (p:0.041); the hematocrit level decreased from 38.1% ± 4.8 to 36.9% ± 4.2 (p:0.026); the median neutrophil count decreased from 4.57 K/uL to 3.85 K/uL (p:0.001); the mean lymphocyte count increased from 1.22 ± 0.53 K/uL to 1.84 ± 1.19 K/uL (p:0.000); and the mean platelet count increased from 244.1 ± 85.1 K/uL to 281.9 ± 103.3 K/uL (p:0.005). CONCLUSION: We concluded that the pathological effect of treatment with favipiravir on the hematologic system was the suppression in the erythrocyte series, and there were no adverse effects in other hematologic parameters.

The effects of favipiravir on hematological parameters of covid-19 patients

SUMMARY INTRODUCTION This study aims to evaluate changes in hematological parameters after the follow-up of patients who received treatment with favipiravir due to COVID-19 infections. METHODS Sixty-two cases receiving favipiravir treatment for at least five days due to COVID-19 infection were evaluated retrospectively. Parameters including age, gender, nasopharyngeal swab positivity, and chronic diseases were analyzed. Hematologic parameters were analyzed before and after the treatment. RESULTS The mean age of the patients receiving treatment with favipiravir was 63.7±12.3 years. Nasopharyngeal swab positivity was detected in 67.7%. The most common comorbid conditions detected in patients were hypertension in 25 cases (40.3%) and diabetes in 16 cases (25.8%). In the statistical analysis of the hematological parameters before and after treatment with favipiravir, WBC, PT-PTT-INR levels were found to be unaffected; the mean RBC was found to have decreased from 4.33 ± 0.58 M/uL to 4.16 ± 0.54 M/uL (p:0.003); the median hemoglobin level was found to have decreased from 12.3 g/dl to 11.9 g/dl (p:0.041); the hematocrit level decreased from 38.1% ± 4.8 to 36.9% ± 4.2 (p:0.026); the median neutrophil count decreased from 4.57 K/uL to 3.85 K/uL (p:0.001); the mean lymphocyte count increased from 1.22 ± 0.53 K/uL to 1.84 ± 1.19 K/uL (p:0.000); and the mean platelet count increased from 244.1 ± 85.1 K/uL to 281.9 ± 103.3 K/uL (p:0.005). CONCLUSION We concluded that the pathological effect of treatment with favipiravir on the hematologic system was the suppression in the erythrocyte series, and there were no adverse effects in other hematologic parameters.

RESUMO INTRODUÇÃO Este estudo tem como objetivo avaliar as alterações nos parâmetros hematológicos após o acompanhamento de pacientes que receberam tratamento com favipiravir devido à infecção por Covid-19. MÉTODOS Sessenta e dois casos em tratamento com favipiravir por pelo menos cinco dias devido à infecção por Covid-19 foram avaliados retrospectivamente. Parâmetros como idade, sexo, positividade do swab nasofaríngeo e doenças crônicas foram analisados. Os parâmetros hematológicos foram analisados antes e após o tratamento. RESULTADOS A idade média dos pacientes que receberam tratamento com favipiravir foi de 63,7±12,3 anos. A positividade do swab nasofaríngeo foi detectada em 67,7%. As condições comórbidas mais comuns detectadas nos pacientes foram hipertensão em 25 casos (40,3%) e diabetes em 16 casos (25,8%). Na análise estatística dos parâmetros hematológicos antes e após o tratamento com favipiravir, os níveis de leucócitos, PT-PTT-INR não foram afetados. Verificou-se que o RBC médio diminuiu de 4,33±0,58 M/uL para 4,16±0,54 M/uL (p=0,003); o nível médio de hemoglobina foi reduzido de 12,3 g/dl para 11,9 g/dl (p=0,041); o nível de hematócrito diminuiu de 38,1%±4,8 para 36,9%±4,2 (p=0,026); a contagem mediana de neutrófilos diminuiu de 4,57 K/uL para 3,85 K/uL (p=0,001); a contagem média de linfócitos aumentou de 1,22±0,53 K/uL para 1,84±1,19 K/uL (p=0,000); a contagem média de plaquetas aumentou de 244,1±85,1 K/uL para 281,9±103,3 K/uL (p=0,005). CONCLUSÃO Concluiu-se que o efeito patológico do tratamento com favipiravir no sistema hematológico foi a supressão na série eritrocitária e que não houve efeitos adversos em outros parâmetros hematológicos.

Comparison of extracorporeal shock wave therapy with custom foot orthotics in plantar fasciitis treatment: A prospective randomized one-year follow-up study.

PURPOSE: Plantar fasciitis (PF) is characterized by the degeneration of the plantar fascia, leading to heel pain. We aimed to investigate the effectiveness of extracorporeal shock wave therapy (ESWT) and custom foot orthotics (CFO). METHOD: The study was planned as a prospective randomized controlled study. In total, 83 patients were evaluated. The patients were divided into two groups: patients treated with ESWT (group I, n=40) and patients treated with CFO (group II, n=43). Visual analogue scale (VAS) was used to evaluate pain in the morning, evening, at rest and while walking. Foot Function Index (FFI) was used to evaluate foot functions, and Foot Health Status Questionnaire (FHSQ) was used to evaluate foot health. RESULTS: Both group I and group II achieved significant improvements in our evaluation parameters (morning and evening pain) at 4, 12 and 24 weeks compared with their baseline values (P<0.001), and significant improvement observed in the group II continued at 48 weeks (P<0.05); however, there was no significant difference in some parameters in the group I after treatment compared with their baseline values (P>0.05). CONCLUSION: Both treatment ESWT and CFO can use interchangebably. Neither method was superior in treating plantar fasciitis.

Assessment of sexual function and quality of life in patients with lower limb amputations.

BACKGROUND: Diseases causing disabilities lead to sexual dysfunction. However, studies that evaluate sexual functions in patients with traumatic lower limb amputations (LLA) are limited and controversial. OBJECTIVE: The objective is to evaluate sexual functions in male patients with LLA and to identify factors that might contribute to sexual dysfunction. The hypothesis is that male patients with LLA would experience worse sexual and emotional functioning and consequently emotional impairment that consequently influenced the sexual function. METHODS: Sixty men with traumatic LLA and 60 healthy men were assessed according to the International Index of Erectile Function (IIEF) scoring system. Emotional state was assessed by the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and the quality of life by the Short Form-36 Health Survey (SF-36). RESULTS: Patients had significantly lower scores in the IIEF total score and subscores in comparison with the controls. Intercourse satisfaction scores were significantly higher (p< 0.05) in patients with trans-tibial amputation than in those with trans-femoral amputation. BDI and BAI scores negatively correlated with erectile function, sexual desire, intercourse satisfaction, overall satisfaction and total IIEF scores. The mental and physical scores of SF-36 significantly correlated with some of the sub scores and IIEF total scores. The power of statistical analysis for study population was 100% according to the given effect size (α= 0.01). CONCLUSION: The present study suggests that the LLA leads to impairments in the sexual function and quality of life in male patients. Also, sexual dysfunction in patients is strongly associated with emotional state, pain, level of amputation and quality of life.

Comparison of the demographic and clinical characteristics, functional status and quality of life of lower extremity amputees to identify the reason for undergoing amputation.

OBJECTIVE: The aim of the study was to evaluate and compare clinical and demographic characteristics, functional status and quality of life among patients who underwent amputation for the most common reason in our region. METHODS: Demographic data, level of and reasons for undergoing amputation and clinical data on the use of prostheses in 126 patients were recorded. The amputees were divided into three groups: vascular, trauma and landmine. Variables related to clinical and demographic characteristics, daily life activities and quality of life were investigated. Duration of prosthesis use, daily walking distance with prosthesis, 10-m walking speed with the prosthesis and 6-min walking distance of the amputees were recorded. The Short Form-36, Turkish version of the Trinity Amputation and Prosthesis Experience Scales and Beck Depression Inventory were used to evaluate the patients' quality of life. The residual limb pain scale was used to evaluate the severity of pain. RESULTS: Comparison between the amputees in the trauma and vascular groups showed highly significant results (P< 0.001) in amputees in the trauma group with respect to all parameters of daily life activities, functional status and quality of life. Comparison between the vascular and landmine amputees showed significant results (P< 0.001) in the landmine amputees with respect to all parameters except emotional role functioning, social functioning and mental health. Comparison between the amputees in the trauma and landmine groups showed no significant results (P> 0.05) with respect to all parameters expect emotional role functioning and mental health. CONCLUSIONS: While the clinical and demographic characteristics, functional status and quality of life parameters were similar in the amputees in the trauma and landmine groups, they showed statistically significant differences in almost all parameters compared with those in vascular amputees.

Comparison of extracorporeal shock-wave therapy and wrist-extensor splint application in the treatment of lateral epicondylitis: a prospective randomized controlled study.

BACKGROUND: Extracorporeal shock-wave therapy (ESWT) and wrist-extensor splints (WESs) are two commonly used methods in the treatment of lateral epicondylitis. In this study, the efficacy of these two methods was compared. METHODS: The study was planned as a prospective randomized controlled study. A total of 67 patients were enrolled. The patients were divided into two groups: group 1 received ESWT (32 patients) and group 2 received WES (35 patients). Patients in group 1 underwent four sessions of ESWT once every week. In each session, an ESWT device at 10-12 Hz, 2,000 pulses, and 1.6-1.8 bar pressure was used. Patients in group 2 used a wrist splint, holding the wrist at 30°-45° extension for 4 weeks. Patients were assessed for handgrip strength, pain at rest, pain while working, and quality of life. Data were collected before and after treatment (at weeks 4, 12, and 24). A visual analog scale was used to evaluate pain at rest and while working, a hand dynamometer for handgrip strength, subscales of the SF36 Health Survey to evaluate quality of life, and the Turkish version of the patient-rated tennis-elbow evaluation was used to evaluate functioning of the affected arm during various daily life activities. RESULTS: In both ESWT and WES groups, although there were considerably significant improvements (P<0.001) in the parameters evaluated (pain at rest and while working, handgrip strength, Patient-Rated Tennis Elbow Evaluation, Nirschl score, and SF36 subscales) were observed at 4, 12, and 24 weeks compared to pretreatment values, there was no statistically significant difference between the two groups in terms of our evaluation parameters at the three time points (P>0.05). CONCLUSION: Both ESWT and WES applications were found to yield significantly superior results when compared to pretreatment values. In comparison of the two groups, on the other hand, there was no statistically significant difference.

Effects of Test Socket on Pain, Prosthesis Satisfaction, and Functionality in Patients with Transfemoral and Transtibial Amputations.

BACKGROUND The aim of this retrospective study was to investigate the frequency of admissions, reason for admissions, and test socket satisfaction in patients who received a lower-limb prosthesis with or without a test socket in our unit. MATERIAL AND METHODS A total of 88 patients (54 men, 34 women) were included in the study. Patients were divided into 2 groups: the group with test socket (Group I, 44 patients) and the group without test socket (Group II, 44 patients). Variables related to the functional status, frequency of complaints, and test socket satisfaction were investigated in the 2 groups. The Trinity Amputation and Prosthesis Experience Scales (TAPES) and Beck Depression Inventory (BDI) were used to assess the level of patient satisfaction with their prosthesis. The VAS (Visual Analogue Scale) was used to assess pain at rest and during walking. RESULTS We found that the TAPES values were more significant in Group 1 in both transtibial and transfemoral amputations (P<0.05). However, prosthesis delivery time was more significant in Group 2 in both transtibial and transfemoral amputations (P<0.001) whereas the frequency of admissions within 3 months was more significant in Group 1 in both transtibial and transfemoral amputations (P<0.001). There was no statistically significant difference between the 2 groups in terms of other parameters (P>0.05). CONCLUSIONS Although the use of a test socket increases the cost of prosthesis units, we showed that patients with transtibial and transfemoral amputations have fewer complaints related to prosthesis increases patient functionality, and that it reduces pain and increases patient satisfaction with the prosthesis.

Sockets Manufactured by CAD/CAM Method Have Positive Effects on the Quality of Life of Patients With Transtibial Amputation.

OBJECTIVE: Patients with amputation need prosthesis to comfortably move around. One of the most important parts of a good prosthesis is the socket. Currently, the most commonly used method is the traditional socket manufacturing method, which involves manual work; however, computer-aided design/computer-aided manufacturing (CAD/CAM) is also being used in the recent years. The present study aimed to investigate the effects of sockets manufactured by traditional and CAD/CAM method on clinical characteristics and quality of life of patients with transtibial amputation. DESIGN: The study included 72 patients with transtibial amputation using prosthesis, 36 of whom had CAD/CAM prosthetic sockets (group 1) and 36 had traditional prosthetic sockets (group 2). Amputation reason, prosthesis lifetime, walking time and distance with prosthesis, pain-free walking time with prosthesis, production time of the prosthesis, and adaptation time to the prosthesis were questioned. Quality of life was assessed using the 36-item Short Form Health Survey questionnaire and the Trinity Amputation and Prosthesis Experience Scales. RESULTS: Walking time and distance and pain-free walking time with prosthesis were significantly better in group 1 than those in group 2. Furthermore, the prosthesis was applied in a significantly shorter time, and socket adaptation time was significantly shorter in group 1. Except emotional role limitation, all 36-item Short Form Healthy Survey questionnaire parameters were significantly better in group 1 than in group 2. Trinity Amputation and Prosthesis Experience Scales activity limitation scores of group 1 were lower, and Trinity Amputation and Prosthesis Experience Scales satisfaction with the prosthesis scores were higher than those in group 2. CONCLUSION: Our study demonstrated that the sockets manufactured by CAD/CAM methods yield better outcomes in quality of life of patients with transtibial amputation than the sockets manufactured by the traditional method.

Rehabilitation in spinal infection diseases.

Spinal cord infections were the diseases defined by Hypocrite yet the absence of modern medicine and there was not a real protocol in rehabilitation although there were many aspects in surgical treatment options. The patients whether surgically or conservatively treated had a lot of neurological, motor, and sensory disturbances. Our clinic has quite experience from our previous researchs. Unfortunately, serious spinal cord infections are still present in our region. In these patients the basic rehabilitation approaches during early, pre-operation, post-operation period and in the home environment will provide significant contributions to improve the patients' sensory and motor skills, develop the balance and proriocaption, increase the independence of patients in daily living activities and minimize the assistance of other people. There is limited information in the literature related with the nature of the rehabilitation programmes to be applied for patients with spinal infections. The aim of this review is to share our clinic experience and summarise the publications about spinal infection rehabilitation. There are very few studies about the rehabilitation of spinal infections. There are still not enough studies about planning and performing rehabilitation programs in these patients. Therefore, a comprehensive rehabilitation programme during the hospitalisation and home periods is emphasised in order to provide optimal management and prevent further disability.

Rehabilitation of spinal cord injuries.

Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. The most common causes of SCI in the world are traffic accidents, gunshot injuries, knife injuries, falls and sports injuries. There is a strong relationship between functional status and whether the injury is complete or not complete, as well as the level of the injury. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI. SCI leads to serious disability in the patient resulting in the loss of work, which brings psychosocial and economic problems. The treatment and rehabilitation period is long, expensive and exhausting in SCI. Whether complete or incomplete, SCI rehabilitation is a long process that requires patience and motivation of the patient and relatives. Early rehabilitation is important to prevent joint contractures and the loss of muscle strength, conservation of bone density, and to ensure normal functioning of the respiratory and digestive system. An interdisciplinary approach is essential in rehabilitation in SCI, as in the other types of rehabilitation. The team is led by a physiatrist and consists of the patients' family, physiotherapist, occupational therapist, dietician, psychologist, speech therapist, social worker and other consultant specialists as necessary.